Isolated tricuspid valve surgery-Repair versus replacement: A meta-analysis

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Medical Outcomes Research

Background:

• Limited data exists on outcomes following isolated tricuspid valve surgery.
• Tricuspid valve disease requires careful management, with repair and replacement as primary surgical options.

Purpose of the Study:

• To compile and analyze existing data on isolated tricuspid valve surgery.
• To compare outcomes between isolated tricuspid valve repair (iTVR) and isolated tricuspid valve replacement (iTVR).

Main Methods:

• A systematic literature search was conducted across six databases.
• Included ten retrospective studies with 1407 patients (779 iTVr, 628 iTVR).
• Primary outcome: 30-day mortality; Secondary outcomes: stroke, pacemaker placement, reoperation.

Main Results:

• iTVr demonstrated significantly lower 30-day mortality (4.7% vs. 12.6%, OR 0.34) compared to iTVR.
• Postoperative pacemaker placement was significantly lower following iTVR (OR 0.37).
• Stroke and reoperation rates favored iTVr but did not reach statistical significance.

Conclusions:

• Isolated tricuspid valve repair is associated with improved 30-day mortality and reduced need for permanent pacemakers.
• The etiology and severity of tricuspid regurgitation, alongside meticulous patient selection, are critical for achieving optimal surgical results.