Key result
Tricuspid valve edge-to-edge repair was associated with better overall survival and freedom from TV-related events compared to tricuspid valve replacement for severe TR.
Why the study?
Non-annuloplasty tricuspid valve repair is challenging and often leads to TVR in complex cases despite TVR's suboptimal outcomes, prompting evaluation of TV edge-to-edge repair versus TVR for severe TR.
Does tricuspid valve edge-to-edge repair improve clinical outcomes compared to tricuspid valve replacement in patients with severe tricuspid regurgitation?
Cohort (n=230)
Does tricuspid valve edge-to-edge repair improve clinical outcomes compared to tricuspid valve replacement in patients with severe tricuspid regurgitation?
Answers are grounded in this paper and cite their sources.
Tricuspid valve edge-to-edge repair is associated with better long-term survival and fewer valve-related events compared to tricuspid valve replacement in patients with severe tricuspid regurgitation.
BACKGROUND AND OBJECTIVES: Tricuspid valve (TV) repair techniques other than annuloplasty remain challenging and frequently end in tricuspid valve replacement (TVR) in complicated cases. However, the results of TVR are suboptimal compared with TV repair. This study aimed to evaluate the clinical effectiveness of TV edge-to-edge repair (E2E) compared to TVR for severe tricuspid regurgitation (TR). METHODS: We retrospectively reviewed 230 patients with severe TR who underwent E2E (n=139) or TVR (n=91) from 2001 to 2020. Clinical and echocardiographic results were analyzed using inverse probability of treatment weighting analysis and propensity score matching. RESULTS: The two groups showed no significant differences in early mortality and morbidities. During the mean follow-up of 106.2±68.8 months, late severe TR and TV reoperation rates were not significantly different between groups. E2E group, however, showed better outcomes in overall survival (p=0.023), freedom from significant tricuspid stenosis (TS) (trans-tricuspid pressure gradient ≥5 mmHg, p=0.021), and freedom from TV-related events (p<0.001). Matched analysis showed consistent results. CONCLUSIONS: E2E for severe TR presented more favorable clinical outcomes than TVR. Our study supports that E2E might be a valuable option in severe TR surgery, avoiding TVR.
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Kim et al. (2023) conducted a cohort in severe tricuspid regurgitation (TR) (n=230). Tricuspid valve edge-to-edge repair (E2E) vs. Tricuspid valve replacement (TVR) was evaluated on overall survival (p=0.023). Tricuspid valve edge-to-edge repair was associated with better overall survival and freedom from TV-related events compared to tricuspid valve replacement for severe TR.
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