Abstract
Objective: There is paucity of data on outcomes after isolated tricuspid
valve surgery. This meta-analysis aims to compile available data on
isolated tricuspid valve surgery and compare isolated tricuspid valve
repair (iTVr) with isolated tricuspid valve replacement (iTVR) to
elucidate outcomes after tricuspid valve surgery. Methods: A literature
search of 6 databases was performed. The primary outcomes was 30-day
mortality. Secondary outcomes were early stroke, post-op pacemaker
placement, and tricuspid reoperation within 5 years. Publication bias
was explored using the funnel plot. Results: Ten retrospective studies
involving 1407 patients (iTVr group = 779 patients and iTVR group = 628
patients) were included. A cumulative analysis demonstrated a
significant difference favoring iTVr for 30-day mortality [odds ratio
– 10 studies (95% confidence interval) 0.34 (0.18-0.66)]; 4.7%
versus 12.6%, for iTVr and iTVR, respectively. Post-op pacemaker
placement favored iTVr [odds ratio – 6 studies (95% confidence
interval) 0.37 (0.18-0.77)]. Although stroke rates and TV reoperation
favored iTVr, they did not reach statistical significance. No
publication bias was identified. Conclusions: This meta-analysis
demonstrates that iTVr has better 30-day mortality and fewer permanent
pacemaker placements. Etiology and severity of TR, as well as careful
patient selection remain the most important factors for optimal
outcomes.