Background: Interventional percutaneous pulmonary valve implantation (PPVI) was first reported
in 2000; today, two different valves are certified for this procedure (Medtronic Melody
valve and Edwards Sapien valves). For a decade, studies have reported an increasing
risk of bacterial endocarditis after PPVI; the published incidence however remains
unclear.
Methods: A systematic literature search in the databases Medline, Cochrane Library, and Embase
including Google Scholar was performed until December 2017. The aim was to summarize
and compare the incidence of endocarditis after percutaneous pulmonary valve replacement.
Results: A total of 741 publications were identified searching for “percutaneous pulmonary
valve implantation and PPVI,” 38 publications were used for final analysis. The follow-up
time was between 2 and 108 months, 2,972 patients with melody valves and 321 with
Sapien valves were included. Endocarditis after percutaneous pulmonary valve replacement
occurred in 151 patients with Melody valves and in 5 patients with Sapien. The pooled
incidence for Melody and Sapien was 4.2% (95% CI: 3.1–5.5) and 2.0 (95% CI: 0.5–3.4),
respectively.
Conclusion: In general, systematic reviews proved an increasing number of endocarditis after
PPVI especially for the Melody valve. To reduce the risk of post-PPVI endocarditis,
the Sapien valves seem to be beneficial. The reason for this finding may be explained
by the different manufacturing process reducing the risk of bacterial adherence in
Sapien valves.
