RT Journal Article SR Electronic T1 A propensity score-adjusted analysis of clinical outcomes after pulmonary valve replacement in tetralogy of Fallot JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 738 OP 744 DO 10.1136/heartjnl-2017-312048 VO 104 IS 9 A1 Jouke P Bokma A1 Tal Geva A1 Lynn A Sleeper A1 Sonya V Babu Narayan A1 Rachel Wald A1 Kelsey Hickey A1 Katrijn Jansen A1 Rebecca Wassall A1 Minmin Lu A1 Michael A Gatzoulis A1 Barbara JM Mulder A1 Anne Marie Valente YR 2018 UL http://heart.bmj.com/content/104/9/738.abstract AB Objective To determine the association of pulmonary valve replacement (PVR) with death and sustained ventricular tachycardia (VT) in patients with repaired tetralogy of Fallot (rTOF).Methods Subjects with rTOF and cardiac magnetic resonance from an international registry were included. A PVR propensity score was created to adjust for baseline differences. PVR consensus criteria were predefined as pulmonary regurgitation >25% and ≥2 of the following criteria: right ventricular (RV) end-diastolic volume >160 mL/m2, RV end-systolic volume >80 mL/m2, RV ejection fraction (EF) <47%, left ventricular EF <55% and QRS duration >160 ms. The primary outcome included (aborted) death and sustained VT. The secondary outcome included heart failure, non-sustained VT and sustained supraventricular tachycardia.Results In 977 rTOF subjects (age 26±15 years, 45% PVR, follow-up 5.3±3.1 years), the primary and secondary outcomes occurred in 41 and 88 subjects, respectively. The HR for subjects with versus without PVR (time-varying covariate) was 0.65 (95% CI 0.31 to 1.36; P=0.25) for the primary outcome and 1.43 (95% CI 0.83 to 2.46; P=0.19) for the secondary outcome after adjusting for propensity and other factors. In subjects (n=426) not meeting consensus criteria, the HR for subjects with (n=132) versus without (n=294) PVR was 2.53 (95% CI 0.79 to 8.06; P=0.12) for the primary outcome and 2.31 (95% CI 1.07 to 4.97; P=0.03) for the secondary outcome.Conclusion In this large multicentre rTOF cohort, PVR was not associated with a reduced rate of death and sustained VT at an average follow-up of 5.3 years. Additionally, there were more events after PVR compared with no PVR in subjects not meeting consensus criteria.