Key result
Isolated tricuspid valve repair was associated with significantly lower 30-day mortality compared to replacement (4.7% vs 12.6%; OR 0.34, 95% CI 0.18-0.66).
Why the study?
Data on outcomes after isolated tricuspid valve surgery are scarce, prompting a comparison between isolated repair and replacement.
Does isolated tricuspid valve repair reduce 30-day mortality compared to isolated tricuspid valve replacement in patients undergoing isolated tricuspid valve surgery?
Meta-Analysis (n=1,407)
Does isolated tricuspid valve repair reduce 30-day mortality compared to isolated tricuspid valve replacement in patients undergoing isolated tricuspid valve surgery?
Odds Ratio: 0.34 (95% CI 0.18–0.66)
Absolute Event Rate: 4.7% vs 12.6%
Isolated tricuspid valve repair is associated with significantly lower 30-day mortality and reduced need for permanent pacemakers compared to replacement.
Isolated tricuspid repair was associated with lower 30-day mortality and pacemaker implantation than replacement; leaves open need for prospective confirmation before practice change.
OBJECTIVE: There is a paucity of data on outcomes after isolated tricuspid valve surgery. This meta-analysis aims to compile available data on isolated tricuspid valve surgery and compare isolated tricuspid valve repair (iTVr) with isolated tricuspid valve replacement (iTVR) to elucidate outcomes after tricuspid valve surgery. METHODS: A literature search of 6 databases was performed. The primary outcomes was 30-day mortality. Secondary outcomes were early stroke, post-op pacemaker placement, and tricuspid reoperation within 5 years. Publication bias was explored using the funnel plot. RESULTS: Ten retrospective studies involving 1407 patients (iTVr group = 779 patients and iTVR group = 628 patients) were included. A cumulative analysis demonstrated a significant difference favoring iTVr for 30-day mortality (odds ratio [OR]: 10 studies [95% confidence interval [CI]]: 0.34 [0.18-0.66]); 4.7% versus 12.6%, for iTVr and iTVR, respectively. Post-op pacemaker placement favored iTVr (OR: 6 studies [95% CI]: 0.37 [0.18-0.77]). Although stroke rates and TV reoperation favored iTVr, they did not reach statistical significance. No publication bias was identified. CONCLUSIONS: This meta-analysis demonstrates that iTVr has better 30-day mortality and fewer permanent pacemaker placements. Etiology and severity of TR, as well as careful patient selection remain the most important factors for optimal outcomes.
No takes yet. Share an insight, caveat, or question.
Sarris‐Michopoulos et al. (2021) conducted a meta-analysis in Isolated tricuspid valve surgery (n=1,407). Isolated tricuspid valve repair (iTVr) vs. Isolated tricuspid valve replacement (iTVR) was evaluated on 30-day mortality (OR 0.34, 95% CI 0.18-0.66). Isolated tricuspid valve repair was associated with significantly lower 30-day mortality compared to replacement (4.7% vs 12.6%; OR 0.34, 95% CI 0.18-0.66).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: