ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Infective endocarditis after transcatheter approach versus surgical pulmonary valve replacement: A meta-analysis
Elif Ijlal Çekirdekçi1, Barış Bugan2, Lütfi Çağatay Onar3, Ahmet Çekirdekçi4
1Department of Cardiology, University of Kyrenia, Kyrenia, Turkish Republic of Northern Cyprus
2Department of Cardiology, Gülhane Training and Research Hospital, Ankara, Türkiye
3Department of Cardiovascular Surgery, Dr. Ismail Fehmi Cumalioglu Government Hospital, Tekirdağ, Türkiye
4Department of Cardiovascular Surgery, Kütahya Health Science University, Kütahya, Türkiye
DOI : 10.5606/tgkdc.dergisi.2022.23506
Background: In this meta-analysis, we aimed to assess the risk of infective endocarditis in transcatheter versus surgical pulmonary valve replacement patients.

Methods: We systematically searched PubMed, Cochrane, EMBASE, Scopus, and Web of Science for the studies that reported the event rate of infective endocarditis in both transcatheter and surgical pulmonary valve replacement between December 2012 and December 2021. Random-effects model was used in the meta-analysis.

Results: Fifteen comparison groups with 4,706 patients were included. The mean follow-up was 38.5±3.7 months. Patients with transcatheter pulmonary valve replacement had a higher risk of infective endocarditis than patients receiving surgically replaced valves (OR 2.68, 95% CI: 1.83-3.93, p<0.00001). The calculated absolute risk difference was 0.03 (95% CI: 0.01-0.05), indicating that if 1,000 patients received a surgical valve replacement, 30 cases of infective endocarditis would be prevented. A meta-regression of follow-up time on the incidence of infective endocarditis was not statistically significant (p=0.753).

Conclusion: Although transcatheter pulmonary valve replacement is a feasible alternative to surgical replacement in severe right ventricular outflow tract dysfunction, the higher incidence of infective endocarditis in transcatheter replacement remains a significant concern. Regarding this analysis, surgical treatment of right ventricular outflow tract dysfunction is still a viable option in patients with prohibitive risk.

Keywords : Infective endocarditis, surgical pulmonary valve replacement, transcatheter pulmonary valve implantation
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