Congenital heart disease

Improved Outcomes After Pulmonary Valve Replacement in Repaired Tetralogy of Fallot

J Am Coll CardiolPublished Retrospective cohort study

Main finding · Death or sustained VTResult — go to the resultAdjusted hazard ratio 0.41 95% CI 0.21–0.81

Authors' conclusion

Compared with rTOF patients who did not receive PVR, propensity score-matched individuals receiving PVR had lower risk of a composite endpoint of death or sustained VT.

Study context

Population
Patients with repaired tetralogy of Fallot (rTOF) in the INDICATOR registrymatched cohort n = 524
Participants
1,143 patients
Exposure
Pulmonary valve replacement (PVR) vs no PVR
Outcome
Time to earliest occurrence of death or sustained VT
Methodological detailspropensity-score matched, multicentre registry
  • Propensity-score matched
  • Multicentre registry

Main finding

Death or sustained VT

Adjusted hazard ratio

0.41

95% CI 0.21–0.81

P = 0.010

PVRvs No-PVR
adjusted HR 0.41 (95% CI 0.21–0.81); P = 0.010

As reported in the abstract

Primary outcome events, whole cohort
82

Observational data: associations, not effects.

Further findings

OutcomeHR (95% CI)P value
Death or sustained VT, by RV end-systolic volume index (subgroup)PVRvs No-PVRRV end-systolic volume index >80 mL/m²0.32 (0.16–0.62)P < 0.001
Death or sustained VT, by RV end-systolic volume index (subgroup)PVRvs No-PVRRV end-systolic volume index ≤80 mL/m²0.86 (0.38–1.92)P = 0.70
  • Death or sustained ventricular tachycardia (VT), by right ventricular (RV) end-systolic volume index (subgroup): interaction P = 0.046; full cohort

Original publication

Improved Outcomes After Pulmonary Valve Replacement in Repaired Tetralogy of Fallot. J Am Coll Cardiol. Published 30 May 2023. doi:10.1016/j.jacc.2023.02.052

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