Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation.

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Research

Background:

• Severe tricuspid regurgitation (TR) impacts survival, but isolated tricuspid valve (TV) surgery is infrequent due to high mortality risks.
• Previous research often combined diverse TR causes, limiting specific insights.
• This study focuses on functional TR to clarify outcomes of isolated TV surgery.

Purpose of the Study:

• To evaluate the early and long-term results of isolated tricuspid valve surgery specifically for functional TR.
• To analyze patient characteristics and surgical approaches in isolated TV surgery for functional TR.

Main Methods:

• A comprehensive electronic literature search was conducted to identify relevant studies.
• Data on patient demographics, surgical variables, and clinical outcomes were extracted.
• A meta-analysis was performed to pool and analyze the collected data.

Main Results:

• The meta-analysis included seven studies, with a majority of patients presenting with atrial fibrillation/flutter (68%) and prior left-sided valve surgery (58%).
• Right-sided heart failure signs (73%) and severe symptoms (NYHA class III/IV, 57%) were common. Tricuspid valve replacement, often with bioprosthetic valves, was more frequent than repair.
• Early mortality was 7%, with 20% requiring permanent pacemakers. One- and 5-year survival rates were 84.5% and 69.1%, respectively.

Conclusions:

• Many patients undergoing isolated TV surgery for functional TR have complex conditions, including prior left-sided procedures and significant heart failure.
• Further research is essential to determine optimal indications for concomitant TV surgery during left-sided procedures.
• Investigating the ideal timing for isolated functional TR surgery is crucial for enhancing patient survival rates.