Congenital heart diseaseMeta-Analysis of Pulmonary Valve Replacement After Operative Repair of Tetralogy of Fallot
Section snippets
Methods
We performed the present systematic review and meta-analysis using the framework proposed by the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.1 Relevant publications in English were identified by searching PubMed (National Library of Medicine) from its inception to April 2009. The terms used for the search were “tetralogy of Fallot” and “pulmonary valve replacement” or “homograft” or “autograft” or “Hancock” or “Contegra” or “valved conduit.” Observational studies
Results
A total of 305 studies were identified and screened, of which 290 were excluded (Figure 1). The characteristics of the 15 studies2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 that met the criteria and were included in this review are summarized in Table 1.
Of these 15 studies, 13 reported early mortality data (n = 595), 11 reported late mortality data (n = 559, 2,415 patient-years), 9 reported on patients undergoing redo-PVR (n = 524, 2,283 patient-years), 5 reported on changes in
Discussion
To our knowledge, this is the first review and meta-analysis of the outcomes of surgical PVR in children and adults after repair of TOF. The pooled data have confirmed the low early and late mortality of PVR in both the pediatric and the adult populations. Although earlier graft deterioration in younger patients has been an issue of concern,17 the pooled redo-PVR rate has been apparently lower in the pediatric than in the adult patients (1.2% vs 2.2%). The interpretation has nonetheless been
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