Abstract

BACKGROUND:

Endocarditis has become a significant concern among patients with congenital anomalies affecting the Right Ventricular Outflow Tract (RVOT) and those with prosthetic valves, emerging as a prominent adverse outcome. The aim of our study is to evaluate the incidence of infective endocarditis post-transcatheter pulmonary valve replacement (TPVR).

METHODS:

We conducted a comprehensive search on PubMed, Scopus, Science Direct, and Clinicaltrials.gov to identify relevant studies, incorporating subject headings and keywords related to "TPVR" and "Endocarditis." Inverse Variance was used to estimate the incidence of IE in patients who underwent TPVR with respective 95% confidence interval (CI). Analysis was performed with RevMan 5.4.1 (Cochrane 2020). A p-value ≤ 0.05 was considered statistically significant.

RESULTS:

We included 18 [1-18] studies with 3270 patients under TPVR. The incidence rate of IE post TPVR is 5.84% [95% CI 3.91%-7.71%; p≤0.00001]. However, when subdivided based on the type of the valve used, TPVR with MELODY valve had a higher incidence [6.99%; 95% CI 4.99%-8.99%; p≤0.00001] of IE when compared to the SAPIEN valve [3.29%; 95% CI 0.53%-6.06%; p≤0.0004].

CONCLUSION:

The incidence of IE post-TPVR is lower with the SAPIEN valve compared to the MELODY valve. Future research has to be done to examine the reasons behind the differential incidence rates since such insights are essential in optimizing patient outcomes and guiding clinical decision-making.