Key result
Ten preoperative risk factors, including older age, female gender, atrial fibrillation, and rheumatic etiology, were significantly associated with residual tricuspid regurgitation.
Why the study?
Do specific preoperative risk factors predict the development of residual tricuspid regurgitation in patients undergoing isolated left-sided valve surgery?
Systematic Review (n=3,138)
Do specific preoperative risk factors predict the development of residual tricuspid regurgitation in patients undergoing isolated left-sided valve surgery?
This meta-analysis identifies 10 key preoperative risk factors that predict the development of residual tricuspid regurgitation after isolated left-sided valve surgery, which may help identify patients who would benefit from concomitant tricuspid repair.
May guide selective concomitant tricuspid repair; extends pooled observational evidence on preoperative risk stratification.
OBJECTIVES: Residual tricuspid regurgitation (TR) that has developed after isolated left-sided valve surgery is not uncommon. Indications for concomitant tricuspid repair at the initial operation have not been well established. The selection of high-risk preoperative patients is of great importance in this situation. METHODS: Six databases were searched to access eligible articles reporting potential risk factors for the development of residual TR. The pooled analysis of risk factors was based on odds ratios or mean differences with their 95% confidence intervals. RESULTS: A total of 3,138 patients with 487 residual TR in 11 studies were analyzed. Of the 14 candidate parameters in our meta-analysis, 10 factors, i.e. older age, female gender, atrial fibrillation, rheumatic etiology, mitral valve surgery, previous valve surgery, a long time from onset to surgery, 2+/3+ TR and enlarged left and right atria, were found to be significantly associated with the development of residual TR. CONCLUSIONS: Our study highlights the role of the above preoperative risk factors in the development of residual TR after isolated left-sided valve surgery and emphasizes the need of further studies to investigate other potential predictors. Moreover, predictive models or scoring systems for the identification of patients at a high risk for developing late TR are urgently needed.
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Zhu et al. (2014) conducted a systematic review in Residual tricuspid regurgitation after isolated left-sided valve surgery (n=3,138). Preoperative risk factors (e.g., older age, female gender, atrial fibrillation, rheumatic etiology) vs. Absence of these risk factors was evaluated on Development of residual tricuspid regurgitation. Ten preoperative risk factors, including older age, female gender, atrial fibrillation, and rheumatic etiology, were significantly associated with residual tricuspid regurgitation.
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