Comparative effects of transcatheter versus surgical pulmonary valve replacement: A systematic review and meta-analysis

Bunchai Chongmelaxme, Kok Pim Kua, Chanokpol Amornvetchayakul, Nichapond Chawviriyathep, Thunyapat Kerdklinhom

Abstract

Transcatheter pulmonary valve replacement (TPVR) is developed as a non-surgical, minimally invasive procedure to reduce the need for re-do cardiac surgical interventions. However, its impacts on patient outcomes are less clear.

Introduction

Congenital heart disease (CHD) is a gross abnormality of the heart structure that is present at birth [1]. Certain defects are manageable and do not necessitate treatment, while others are more complicated and may require several surgeries performed sequentially over growing years [1,2].

Materials and methods

An electronic literature search was performed from inception to March 1, 2024, on the following databases: PubMed, Cochrane CENTRAL, EMBASE, CINAHL Complete, and Web of Science. All the search terms are presented in S1 Table.

Results

The initial search yielded 7,772 articles, of which 1,818 duplicates were removed. The remaining 5,950 articles were screened on the basis of titles and abstracts. A total of 629 were excluded because of their irrelevance to PV or RVOT dysfunctions and the study designs.

Discussion

This study provided a comprehensive synthesis of the best available evidence regarding the effects of TPVR compared with SPVR among the CHD patients with PV and RVOT dysfunctions. Our findings revealed that TPVR reduced the risks of mortality, but it was associated with an elevated risk of IE.

Conclusion

Compared to SPVR, TPVR showed benefits in terms of mortality, however, it was associated with an increased risk of IE. Our findings are expected to provide healthcare professionals and policy makers with all presently available high-quality evidence on the clinical effects of TPVR to promote its integration and application in practice environments.

Citation: Chongmelaxme B, Kua KP, Amornvetchayakul C, Chawviriyathep N, Kerdklinhom T (2025) Comparative effects of transcatheter versus surgical pulmonary valve replacement: A systematic review and meta-analysis. PLoS One 20(5): e0322041. https://doi.org/10.1371/journal.pone.0322041

Editor: Eyüp Serhat Çalık, Ataturk University Faculty of Medicine, TÜRKIYE

Received: December 18, 2023; Accepted: March 14, 2025; Published: May 20, 2025

Copyright: © 2025 Chongmelaxme et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting information files.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.