Key result
3D rigid ring annuloplasty reduces 5-year tricuspid regurgitation recurrence ~74% versus suture annuloplasty.
Why the study?
Tricuspid annuloplasty is the standard technique for correcting tricuspid regurgitation, but an overview of contemporary results of 3D rigid ring annuloplasty was needed.
Does 3D rigid ring annuloplasty improve postoperative TR grade and reduce recurrent TR compared to flexible bands or suture annuloplasty in patients with tricuspid regurgitation?
Meta-Analysis (n=1,949)
Does 3D rigid ring annuloplasty improve postoperative TR grade and reduce recurrent TR compared to flexible bands or suture annuloplasty in patients with tricuspid regurgitation?
Effect estimate: OR 0.26 (95% CI 0.13, 0.50)
p-value: p=<0.05
3D rigid ring annuloplasty provides similar short-term outcomes to flexible bands but superior outcomes to suture annuloplasty for the treatment of tricuspid regurgitation.
Supports 3D rigid rings for durable TR repair; extends evidence favoring rigid over suture annuloplasty.
Background Tricuspid annuloplasty (TAP) is accepted as the standard technique for correcting tricuspid regurgitation (TR). We conducted the present study to provide an overview of the contemporary results of 3D rigid ring annuloplasty for TR. Methods A systematic literature search was carried out in eight databases to collect all relevant studies on the three-dimensional (3D) rigid ring annuloplasty treatment of TR published before October 1, 2020. The main outcomes of interest were postoperative TR grade, perioperative mortality, and recurrent TR. Results A total of eight studies were included, all of which were retrospective observational studies. Rigid 3D rings were compared with flexible bands, and there was no difference in perioperative mortality [odds ratio ( OR ) = 1.02; 95% CI (0.52, 2.02); p = 0.95], late mortality [ OR = 0.99; 95% CI (0.28, 3.50); p = 0.98], or recurrent TR [ OR = 0.59; 95% CI (0.29, 1.21); p = 0.15]. The postoperative TR grade associated with 3D rigid rings was 0.12 lower [mean difference (MD) = −0.12; 95% CI (−0.22, −0.01); p = 0.03], which indicated that 3D rigid rings result in better postoperative outcomes than flexible bands. Compared with suture annuloplasty, the postoperative TR grade of the 3D rigid ring group was 0.51 lower [MD = −0.51; 95% CI (−0.59, −0.43); p < 0.05]. Within the 5 years of follow-up, patients who underwent 3D rigid ring annuloplasty had lower TR recurrence [ OR = 0.26; 95% CI (0.13, 0.50); p < 0.05]. Conclusions Compared with suture annuloplasty, 3D rigid rings present early advantages. The 3D rigid rings provide an acceptable short-term effect similar to that of the flexible bands, and a significant difference between these approaches was not discovered. However, the conclusion was based on the limited, short-term data available at the time of the study. Further research on the long-term effects of 3D rigid ring annuloplasty for TR is clearly needed. Systematic Review Registration https://inplasy.com/inplasy-2021-3-0105/ , identifier: 202130105.
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You et al. (2022) conducted a meta-analysis in Tricuspid Regurgitation (n=1,949). 3D rigid ring annuloplasty vs. Suture annuloplasty or flexible band annuloplasty was evaluated on Recurrent tricuspid regurgitation (vs suture annuloplasty) (OR 0.26, 95% CI 0.13, 0.50, p=<0.05). 3D rigid ring annuloplasty significantly reduced tricuspid regurgitation recurrence within 5 years compared to suture annuloplasty (OR 0.26), but showed similar short-term effects to flexible bands.
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