Document Detail


Meta-analysis of pulmonary valve replacement after operative repair of tetralogy of fallot.
MedLine Citation:
PMID:  20691315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The present meta-analysis aimed to determine the outcomes and effect on right ventricular (RV) function of surgical pulmonary valve replacement (PVR) in patients after repair of tetralogy of Fallot. The reported outcomes of surgical PVR in children and adults after tetralogy of Fallot repair were from relatively small observational studies. The PubMed database was searched from its inception to April 2009. Observational studies reporting on the following outcomes measures after surgical PVR were reviewed: early and late all-cause mortalities, the redo-PVR rate, and changes in the indexed RV volumes, ejection fraction, and QRS duration after PVR. Of the 305 citations screened, 15 met the criteria and were analyzed. The pooled early mortality rate (n = 595) was 2.1% (95% confidence interval [CI] 1.1% to 4.0%). The late mortality rate was 0.5%/patient-year (95% CI 0.2% to 0.8%/patient-year), and the redo-PVR rate was 1.9%/patient-year (95% CI 1.3% to 2.5%/patient-year). Data on RV volumes and ejection fractions were available from 5 studies (n = 141). The pooled mean difference in the indexed RV end-diastolic and end-systolic volume was -63 ml/m(2) (95% CI -55 to -72) and -37 ml/m(2) (95% CI -30 to -45), respectively. No significant changes in the pooled mean difference of the RV ejection fraction (95% CI -1% to 3%) or QRS duration (95% CI -10 to 1 ms) were observed. In conclusion, surgical PVR in patients after tetralogy of Fallot repair has been associated with low early and late mortality and significant decreases in RV volumes but no changes in the RV ejection fraction or QRS duration.
Authors:
Eddie Wai-Yin Cheung; Wilfred Hang-Sang Wong; Yiu-Fai Cheung
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  552-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, People's Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Child
Heart Valve Prosthesis Implantation* / mortality
Humans
Postoperative Period
Pulmonary Valve / surgery*
Stroke Volume
Tetralogy of Fallot / surgery*
Treatment Outcome
Ventricular Dysfunction, Right / physiopathology
Ventricular Function, Right / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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