Congenital heart diseaseCohort study
The Evolving Clinical Profile of Patients with Repaired Tetralogy of Fallot Undergoing Pulmonary Valve Replacement
- retrospective, single-center cohort study
- matched controls without pulmonary valve replacement (PVR)
- stratified by era (1995-2003 vs. 2004-2012 vs. 2013-2021)
Authors' conclusion
This study highlights more proactive referral to PVR in rTOF and increasing use of tPVR. Further study is required to determine whether these evolving practices improve clinical outcomes.
Study context
- Population
- Patients with repaired tetralogy of Fallot (rTOF) who had undergone PVR, at Boston Children's Hospital
- Exposure
- time trends in referral patterns for sPVR versus tPVR
Main finding
As reported in the abstract
Age at TOF repair
- Over time, patients underwent TOF repair at a younger age
Observational data: associations, not effects.
Further findings
| Outcome | Era 1 | Era 2 | Era 3 | matched controls without PVR |
|---|---|---|---|---|
| Percentage of tPVR | 0% | 21% | 38% | Not reported in the abstract |
- Percentage of tPVR: p<0.001
Clinical profile of patients referred for PVR
- Age at the time of PVR remained stable
- Burden of heart failure symptoms and arrhythmias decreased, as did the severity of RV dilation and dysfunction
tPVR among those with a transannular patch repair
- from 0% to 27% to 47% across eras
- P < 0.001
- increase in tPVR particularly pronounced among patients with TOF and pulmonary stenosis
sPVR in patients with a right ventricle-to-pulmonary artery conduit
- decreased from 20% to 12% to 5% across eras
- P < 0.001
Original publication
The Evolving Clinical Profile of Patients with Repaired Tetralogy of Fallot Undergoing Pulmonary Valve Replacement. Am Heart J. Published 23 September 2026. doi:10.1016/j.ahj.2026.107614
Summarised from the published abstract; every number is checked against it