Tricuspid valve repair outperforms replacement, new meta-analysis confirms
Isolated tricuspid valve (TV) repair is associated with better short-term and long-term survival rates than TV replacement, according to a new meta-analysis published in the American Journal of Cardiology.
Researchers examined outcomes data from 21 different studies published through February 2021, running a separate analysis to ensure there were no signs of publication bias. The studies included a total of 8,729 TV repairs and 9,801 TV replacements.
Overall, short-term mortality was 8.24% for the TV repair group and 9.82% for the TV replacement group. Long-term mortality, meanwhile, was 14.38% for the TV repair group and 18.05% for the TV replacement group.
“Increased mortality with TV replacement can be attributed to a higher risk of thrombosis or bleeding with the prosthetic valves,” wrote lead author Agam Bansal, MD, of the Heart and Vascular Institute at Cleveland Clinic, and colleagues. “Another long-term issue with TV replacement is that when a rigid prosthetic valve is implanted in a deformable, low-pressure activity, it could lead to progressive right ventricular dysfunction.”
The team did note that their study had one primary limitation: they were unable to confirm how many patients may have undergone TV replacement but were not even a candidate for tricuspid repair. Even with that in mind, however, Bansal et al. described their findings as “important” for its updated evaluation of these two treatment methods.
“In patients with severe tricuspid regurgitation, efforts should be exercised to increase the utilization and encourage earlier referral for isolated TV repair,” the authors concluded.
The full meta-analysis is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.