Isolated tricuspid valve surgery—Repair versus replacement: A meta‐analysis

Sarris-Michopoulos, Panagiotis; Macias, Alejandro E.; Sarris-Michopoulos, Constantine; Woodhouse, Palina; Buitrago, Daniel; Salerno, Tomás A.; Magarakis, Michael

doi:10.1111/jocs.16131

Cited by 13 publications

(3 citation statements)

References 21 publications

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“…Moreover, our study confirmed that TVR is associated with a numerically higher 30day mortality than TVr: 8.0% vs 4.0% even after stratifying patients for preoperative and intraoperative features. This evidence is in line with a recent metanalysis involving 1407 patients, which reported favourable early mortality and rate of pacemaker implantation when considering TVr [26].…”

Section: Thirty-day Outcomesupporting

confidence: 89%

Outcome of patients undergoing isolated tricuspid repair or replacement surgery

Russo

Mauro

Saitto

et al. 2022

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES The interest in isolated tricuspid valve disease has rapidly increased recently. However, clinical trials and registry data are rare in the surgical literature. This study aimed to describe the early and long-term outcomes of a real-world experience in isolated tricuspid procedures comparing repair and replacement strategies. METHODS The Surgical-Tricuspid study is a multicentre retrospective study that enrolled adult patients who had undergone isolated tricuspid valve surgery at 13 international sites. Propensity score-matched analysis was used to compare repair versus replacement. RESULTS A cohort of 426 patients was enrolled [mean age: 55 (16) years; 56% female]. After matching, 175 comparable pairs were analysed. Preoperative left ventricular ejection fraction was 55(9) vs 56(9) (P = 0.8) while moderate–severe tricuspid regurgitation was present in 95% of cases. The 30-day mortality rate was 4.0% vs 8.0% in the repair and replacement groups, respectively (P = 0.115). The rates of re-exploration for bleeding (6.9% vs 13.1% P = 0.050), permanent pacemaker implantation (5.1% vs 12.0%; P = 0.022) and blood transfusion (46% vs 62%; P = 0.002) were higher in the replacement group. Cumulative survival rates at 3, 5 and 7 years in the repair group were 84 (3)%, 75 (4)% and 56 (9)% vs 71 (4)%, 66 (5)% and 58 (5)% in the replacement group (P = 0.001) while cumulative incidence for reoperation at 10 years did not differ between groups [repair 10 (1)% vs replacement 9 (1)%; P = 0.469]. CONCLUSIONS The data from the Surgical-Tricuspid study reported a high risk for patients undergoing tricuspid surgery. Isolated valve repair offered reduced early and late mortality with no difference regarding reoperation rate when compared with replacement.

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Section: Thirty-day Outcomesupporting

confidence: 89%

Outcome of patients undergoing isolated tricuspid repair or replacement surgery

Russo

Mauro

Saitto

et al. 2022

European Journal of Cardio-Thoracic Surgery

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“…Similar to other reports [ 23 , 24 ], compared with STVR or STVr, our study demonstrated that patients who underwent TTVr were older and had higher burden of comorbidities such as heart failure, hyperlipemia, renal failure, and chronic obstructive pulmonary disease suggesting that a larger proportion of patients may be at higher risk of surgery. Although patients who underwent TTVr were older than those who underwent STVR or STVr groups, the TTVr group has higher in-hospital mortality, indicating that STVR or STVr maybe far behind TTVr in surgical safety, but more clinical studies were needed to confirm the result.…”

Section: Discussionsupporting

confidence: 89%

Comparison of outcomes between transcatheter tricuspid valve repair and surgical tricuspid valve replacement or repair in patients with tricuspid insufficiency

Wang

Liu

et al. 2023

J Cardiothorac Surg

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Background Tricuspid regurgitation is associated with significant morbidity and mortality, but with limited treatment options. The objective of this study is to compare the demographic characteristics, complications, and outcomes of transcatheter tricuspid valve repair (TTVr) versus surgical tricuspid valve replacement (STVR) or surgical tricuspid valve repair (STVr), using real-world data from the National Inpatient Sample (NIS) database. Methods and results Our study analyzed data from the National Inpatient Sample (NIS) database from 2016 to 2018 and identified 92, 86, and 84 patients with tricuspid insufficiency who underwent STVr, STVR, and TTVr, respectively. The mean ages of patients who received STVr, STVR, and TTVr were 65.03 years, 66.3 years, and 71.09 years, respectively, with TTVr patients significantly older than those who received STVr (P < 0.05). Patients who received STVr or STVR had higher mortality rates (8.7% and 3.5%, respectively) compared to those who received TTVr (1.2%). Patients who underwent STVr or STVR were also more likely to experience perioperative complications, including third-degree atrioventricular block (8.7% STVr vs. 1.2% TTVr, P = 0.329; 38.4% STVR vs. 1.2% TTVr, P < 0.05), respiratory failure (5.4% STVr vs. 1.2% TTVr, P = 0.369; 15.1% STVR vs. 1.2% TTVr, P < 0.05), respiratory complications (6.5% STVr vs. 1.2% TTVr, P = 0.372; 19.8% STVR vs. 1.2% TTVr, P < 0.05), acute kidney injury (40.2% STVr vs. 27.4% TTVr, P = 0.367; 34.9% STVR vs. 27.4% TTVr, P = 0.617), and fluid and electrolyte disorders (44.6% STVr vs. 22.6% TTVr, P = 0.1332; 50% STVR vs. 22.6% TTVr, P < 0.05). In addition, the average cost of care and the average length of hospital stay were higher for patients who underwent STVr or STVR than for those who received TTVr (USD$37995 ± 356008.523 STVr vs. USD$198397 ± 188943.082 TTVr, P < 0.05; USD$470948 ± 614177.568 STVR vs. USD$198397 ± 188943.082 TTVr, P < 0.05; 15.4 ± 15.19 STVr vs. 9.6 ± 10.21 days TTVr, P = 0.267; 24.7 ± 28.81 STVR vs. 9.6 ± 10.21 days TTVr, P < 0.05). Conclusion TTVr has shown to have favorable outcomes compared to STVr or STVR, but more research and clinical trials are required to help formulate evidence-based guidelines for the role of catheter-based management in tricuspid valve disease.

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“…Recent studies have found, however, that the risk of CVA is similar to the use of retrograde perfusion in selected patients [ 50 ]. MATVS in reported series has been shown to have a 0–4% risk of CVA, which is akin to the rates in meta-analyses of open surgery comparing repair vs. replacement (stroke risk 1.5% vs. 0.9%) [ 51 , 52 ].…”

Section: Outcomes Of Matvsmentioning

confidence: 98%

Minimal Access Tricuspid Valve Surgery

Sauvé

Ghatanatti

et al. 2023

JCDD

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Tricuspid valve diseases are a heterogeneous group of pathologies that typically have poor prognoses when treated medically and are associated with significant morbidity and mortality with traditional surgical techniques. Minimal access tricuspid valve surgery may mitigate some of the surgical risks associated with the standard sternotomy approach by limiting pain, reducing blood loss, lowering the risk of wound infections, and shortening hospital stays. In certain patient populations, this may allow for a prompt intervention that could limit the pathologic effects of these diseases. Herein, we review the literature on minimal access tricuspid valve surgery focusing on perioperative planning, technique, and outcomes of minimal access endoscopic and robotic surgery for isolated tricuspid valve disease.

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Isolated tricuspid valve surgery—Repair versus replacement: A meta‐analysis

Cited by 13 publications

References 21 publications

Outcome of patients undergoing isolated tricuspid repair or replacement surgery

Outcome of patients undergoing isolated tricuspid repair or replacement surgery

Comparison of outcomes between transcatheter tricuspid valve repair and surgical tricuspid valve replacement or repair in patients with tricuspid insufficiency

Minimal Access Tricuspid Valve Surgery

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