Key result
Tricuspid valve repair during mitral valve surgery did not improve 30-day mortality (RR 1.19; 95% CI 0.70-2.02) or late mortality, but reduced late moderate or greater TR (IRR 0.28; 95% CI 0.17-0.47).
Why the study?
The surgical management of tricuspid regurgitation at the time of mitral valve surgery remains controversial.
Does tricuspid valve repair at the time of mitral valve surgery reduce mortality or late tricuspid regurgitation compared to no intervention?
Population
Patients across 17 studies undergoing mitral valve surgery
Comparison
TV repair vs no intervention
Design
Random-effects meta-analysis of 17 studies
Follow-up
Mean 6.0 ± 0.64 years
Authors
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Concomitant TV repair may reduce late TR progression without raising mortality; extends observational support for selective use but leaves practice change open pending RCTs.
Meta-Analysis (n=67,814)
Does tricuspid valve repair at the time of mitral valve surgery reduce mortality or late tricuspid regurgitation compared to no intervention?
Relative Risk: 1.19 (95% CI 0.7–2.02)
p-value: p=0.52
Tricuspid valve repair during mitral valve surgery reduces the risk of late recurrent tricuspid regurgitation but increases the risk of permanent pacemaker implantation without conferring a survival benefit.
Tam et al. (2019) conducted a meta-analysis in Tricuspid regurgitation at the time of mitral valve surgery (n=67,814). Tricuspid valve repair vs. No intervention was evaluated on 30-day/in-hospital mortality (RR 1.19, 95% CI 0.70-2.02, p=0.52). Tricuspid valve repair during mitral valve surgery did not improve 30-day mortality (RR 1.19; 95% CI 0.70-2.02) or late mortality, but reduced late moderate or greater TR (IRR 0.28; 95% CI 0.17-0.47).
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