Mechanical tricuspid valve replacement in hypoplastic left heart syndrome: An institutional experience

Hoda, Mehar; Jaquiss, Robert D.B.; James, Lorraine; Thankavel, Poonam P.

doi:10.1016/j.xjon.2022.06.015

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…Right ventricular (RV) dominance exposes univentricular patients to an increased risk of clinically signi cant atrioventricular valve regurgitation, which translates into poor early and long-term transplant-free survival [7][8][9][10]. Hypoplastic left heart syndrome (HLHS) represents the prototype of this condition [11] and 15-25% of affected patients are expected to require surgical management of TV regurgitation (TVR) during their palliation course [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…In fact, evidence supporting the e cacy of TV repair in reverting the (un)natural progression of RV adverse remodeling and preventing TVR recurrence in HLHS is con icting [14,20,[22][23][24]. This ultimately turns into a poorly predictable long-term outcome even for HLHS patients in whom a successful TV repair has been achieved [12,[14][15][16]. Moreover, the very small sample size of surgical cohorts dramatically limits the generalization of ndings.…”

Section: Introductionmentioning

confidence: 99%

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Tricuspid valve repair can restore the prognosis of patients with hypoplastic left heart syndrome and tricuspid valve regurgitation: a meta-analysis

Ponzoni

Azzolina

Vedovelli

et al. 2023

Preprint

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Objectives To date, evidence supporting the efficacy of tricuspid valve (TV) repair in interrupting the progression of systemic right ventricular (RV) adverse remodeling in hypoplastic left heart syndrome (HLHS) is conflicting. We performed a systematic review and meta-analysis of scientific literature to assess the impact of TV repair in effectively modifying the prognosis of patients with HLHS. Methods We conducted a systematic review of PubMed, Web of Science, and Scopus databases. A random-effect meta-analysis was performed and transplant-free survival, freedom from TV regurgitation, and TV reoperation data were reconstructed using the published Kaplan–Meier curves. Results Nine studies were included, for a total of 203 HLHS patients undergoing TV repair and 323 HLHS controls. The estimated transplant-free survival at 1, 5, and 10 years of follow-up was 75.5% [95% confidence interval (CI) = 67.6–84.3%], 63.6% [95% CI = 54.6–73.9%], and 61.9% [95% CI = 52.7–72.6%], respectively. Transplant-free survival was comparable to HLHS peers without TV regurgitation (p = 0.59). Five-year freedom from recurrence of TV regurgitation and freedom from TV reoperation was 57% [95% CI = 46.7–69.7%] and 63.6% [95% CI = 54.5–74.3%], respectively. Younger age and TV repair at the time of Norwood operation increased the risk of TV regurgitation recurrence and the need for TV reoperation. Conclusions Our meta-analysis supports the efficacy of TV repair in modifying favorably the prognosis of patients with HLHS and TV regurgitation, reestablishing a medium-term transplant-free survival which is comparable to HLHS peers. However, durability of surgery and long-term fate of TV and RV performance are still unclear.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tricuspid valve repair can restore the prognosis of patients with hypoplastic left heart syndrome and tricuspid valve regurgitation: a meta-analysis

Ponzoni

Azzolina

Vedovelli

et al. 2023

Preprint

View full text Add to dashboard Cite

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Tricuspid Valve Repair Can Restore the Prognosis of Patients with Hypoplastic Left Heart Syndrome and Tricuspid Valve Regurgitation: A Meta-analysis

et al. 2023

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To date, evidence supporting the efficacy of tricuspid valve (TV) repair in interrupting the progression of systemic right ventricular (RV) adverse remodeling in hypoplastic left heart syndrome (HLHS) is conflicting. We conducted a systematic review and meta-analysis of scientific literature to assess the impact of TV repair in effectively modifying the prognosis of patients with HLHS. We conducted a systematic review of PubMed, Web of Science, and Scopus databases. A random-effect meta-analysis was performed and transplant-free survival, freedom from TV regurgitation, and TV reoperation data were reconstructed using the published Kaplan–Meier curves. Nine studies were included, comprising 203 HLHS patients undergoing TV repair and 323 HLHS controls. The estimated transplant-free survival at 1, 5, and 10 years of follow-up was 75.5% [95% confidence interval (CI) = 67.6–84.3%], 63.6% [95% CI = 54.6–73.9%], and 61.9% [95% CI = 52.7–72.6%], respectively. Transplant-free survival was comparable to HLHS peers without TV regurgitation (p = 0.59). Five-year freedom from recurrence of TV regurgitation and freedom from TV reoperation was 57% [95% CI = 46.7–69.7%] and 63.6% [95% CI = 54.5–74.3%], respectively. Younger age and TV repair at the time of Norwood operation increased the risk of TV regurgitation recurrence and the need for TV reoperation. Our meta-analysis supports the efficacy of TV repair in favorably modifying the prognosis of patients with HLHS and TV regurgitation, reestablishing a medium-term transplant-free survival which is comparable to HLHS peers. However, durability of surgery and long-term fate of TV and RV performance are still unclear. Graphical Abstract

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Ventricular Assist Device Implantation in Children with a Mechanical Valve: An ACTION Registry Analysis

Hussain,

Miller,

MBBS

et al. 2024

JHLT Open

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Mechanical tricuspid valve replacement in hypoplastic left heart syndrome: An institutional experience

Cited by 4 publications

References 28 publications

Tricuspid valve repair can restore the prognosis of patients with hypoplastic left heart syndrome and tricuspid valve regurgitation: a meta-analysis

Tricuspid valve repair can restore the prognosis of patients with hypoplastic left heart syndrome and tricuspid valve regurgitation: a meta-analysis

Tricuspid Valve Repair Can Restore the Prognosis of Patients with Hypoplastic Left Heart Syndrome and Tricuspid Valve Regurgitation: A Meta-analysis

Ventricular Assist Device Implantation in Children with a Mechanical Valve: An ACTION Registry Analysis

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