Abstract
Background Tricuspid valve (TV) repair at the time of left-sided valve surgery is indicated in patients with either severe functional tricuspid regurgitation (TR) or mild-to-moderate TR with coexistent tricuspid annular dilation or right heart failure. We assessed the benefits of a concomitant TV repair strategy during left-sided surgical valve interventions, focusing on mortality and echocardiographic TR-related outcomes. Methods A meta-analysis was performed of studies reporting outcomes of patients who underwent left-sided (mitral and/or aortic) valve surgery with or without concomitant TV repair. Primary endpoints were all-cause and cardiac-related mortality; secondary endpoints were the presence of more-than-moderate TR, TR progression, and TR severity grade. All endpoints were evaluated at the longest available follow-up. Results Fifteen studies were included for a total of 2840 patients. TV repair at the time of left-sided valve surgery was associated with a significantly lower risk of cardiac-related mortality (odds ratio [OR] 0.38; 95% confidence interval [CI]: 0.25–0.58; p < 0.001), with a trend towards a lower risk of all-cause mortality (OR 0.57; 95% CI: 0.32–1.05; p = 0.07) at a mean weighted follow-up of 6 years. The presence of more-than-moderate TR (OR 0.19; 95% CI: 0.12–0.30; p < 0.001), TR progression (OR 0.03; 95% CI: 0.01–0.05; p < 0.001), and TR grade (standardized mean difference − 1.11; 95% CI: − 1.57 to − 0.65; p < 0.001) were significantly lower in the TV repair group at a mean weighted follow-up of 4.7 years. Conclusions A concomitant TV repair strategy during left-sided valve surgery is associated with a reduction in cardiac-related mortality and improved echocardiographic TR outcomes at follow-up.
Original language | English (US) |
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Pages (from-to) | 138-144 |
Number of pages | 7 |
Journal | International Journal of Cardiology |
Volume | 240 |
DOIs | |
State | Published - Aug 1 2017 |
Externally published | Yes |
Keywords
- Cardiac surgery
- Meta-analysis
- Tricuspid annuloplasty
- Tricuspid regurgitation
- Tricuspid valve repair
- Valvular heart disease
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine