AUTHOR=Yi Kang , Wang Dan , Xu Jianguo , Zhang Xin , Wang Wenxin , Gao Jie , Wang Wei , You Tao , Tian Jinhui 

TITLE=Surgical Strategies for Preservation of Pulmonary Valve Function in a Radical Operation for Tetralogy of Fallot: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.888258

DOI=10.3389/fcvm.2022.888258

ISSN=2297-055X

ABSTRACT=Objective: To evaluate the efficacy and safety of different surgical strategies to preserve pulmonary valve function. The evaluated surgical procedures include intraoperative balloon pulmonary valvuloplasty (IBPV)，pulmonary valve reconstruction，commissurotomy and pulmonary cusp augmentation (PCA) in patients who underwent radical operation for Tetralogy of Fallot (TOF).
Methods: Five databases searched in the current study include the Cochrane Library, PubMed, China National Knowledge Infrastructure, VIP and WanFang data. A systematic search for control trials was performed in each database from the starting date of each database to December 2021. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of included studies. 
Results: Fifteen retrospective studies were included in the current study with a total number of 1396 participants. In subgroup 1 (IBPV vs TAP), patients underwent IBPV had a less degree of regurgitation within 1-2 years after surgery. Reintervention rate increased in the IBPV group within 5 years. In subgroup 2 (pulmonary valve reconstruction vs TAP), the degree of regurgitation decreased in pulmonary valve reconstruction group within a month after surgery. In subgroup 3 (valve-sparing operation vs TAP), the comparison demonstrated decreased rates for surgical mortality and reintervention within 5-10 years after the surgery, respectively.
Conclusions: We suggest preserving the pulmonary valve function in radical operations for TOF. IBPV, pulmonary valve reconstruction, and commissurotomy and pulmonary cusp augmentation can be performed during the surgical procedure based on the development status and the anatomical characteristics of the right ventricular outflow tract, pulmonary valve and pulmonary artery.