Key result
Mechanical tricuspid valve replacement was associated with a significantly higher risk of valve thrombosis compared to bioprosthetic valves (RR 6.52; 95% CI 3.00-14.15; p<0.00001).
Why the study?
The study was conducted to analyze clinical results of tricuspid valve replacement and compare outcomes between different types of tricuspid valve prostheses.
Does a bioprosthetic tricuspid valve prosthesis reduce morbidity compared to a mechanical tricuspid valve prosthesis in adults undergoing tricuspid valve replacement?
Meta-Analysis (n=2,219)
Does a bioprosthetic tricuspid valve prosthesis reduce morbidity compared to a mechanical tricuspid valve prosthesis in adults undergoing tricuspid valve replacement?
Relative Risk: 6.52 (95% CI 3–14.15)
p-value: p=<0.00001
In adults undergoing tricuspid valve replacement, bioprosthetic valves are associated with significantly lower risks of valve thrombosis and emboli compared to mechanical valves, with no difference in other major complications.
Tricuspid prosthesis selection should prioritize patient characteristics; confirms original valve disease as dominant long-term determinant.
Background: The long-term results of Tricuspid Valve Replacement (TVR) depend on factors related to the original valve disease more than on the prosthesis type. Tricuspid valve prosthesis; either mechanical or bioprosthetic, should be chosen according to the individual patient's characteristics.Aim of Study: The aim of the study was to analyze the clinical results of tricuspid valve replacement, comparing the different types of tricuspid valve prostheses.Patients and Methods: A meta-analysis study was done to evaluate TVR results in adults in the literature published in the period of 20 years “1995: 2015”, focusing on literature published in English comparing mechanical valves to bio-prosthetic valves. We performed a search over published literature of different databases “Embase, PubMed, Ovid, Justor, Science Direct, and Wiley Blackwell.”Results: The total of 17 studies evaluating 1020 mechanical valve and 1199 bioprosthetic valve patients were included in the meta-analysis. Valve thromboses, and emboli are less reported with bioprosthetic valve (RR=6.52; 95% CI: 3.00, 14. 15; p<0.00001) and (RR=2.25; 95% CI: 1.14, 4.46; p= 0.02) respectively. There was no statistically significant difference between valve types as regards to bleeding, heart block, low cardiac output, valve failure, infective endocarditis, stroke, and renal failure.Conclusion: The type of the tricuspid valve prosthesis should be chosen based on patient's characteristics but occa-sionally it's equivocal, that's when the bioprosthetic valve should be preferred because of its less morbidity.
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Negm et al. (2019) conducted a meta-analysis in Tricuspid Valve Disease (n=2,219). Mechanical valve vs. Bioprosthetic valve was evaluated on Valve thrombosis (RR 6.52, 95% CI 3.00-14.15, p=<0.00001). Mechanical tricuspid valve replacement was associated with a significantly higher risk of valve thrombosis compared to bioprosthetic valves (RR 6.52; 95% CI 3.00-14.15; p<0.00001).
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