Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysis
Abstract Objectives There is controversy over the optimal management of moderate tricuspid valve regurgitation during left-sided valve surgery due to the paucity of robust evidence for enhanced outcomes from concomitant tricuspid valve repair. Hence, we assessed the literature to compare clinical ou...
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BMC
2025-07-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03464-0 |
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| author | Anupama Barua Nicholas Wong Shubham Jain Mohsin Uzzaman Prakash Nanjaiah Ravish Jeeji Lognathen Balacumaraswami |
| author_facet | Anupama Barua Nicholas Wong Shubham Jain Mohsin Uzzaman Prakash Nanjaiah Ravish Jeeji Lognathen Balacumaraswami |
| author_sort | Anupama Barua |
| collection | DOAJ |
| description | Abstract Objectives There is controversy over the optimal management of moderate tricuspid valve regurgitation during left-sided valve surgery due to the paucity of robust evidence for enhanced outcomes from concomitant tricuspid valve repair. Hence, we assessed the literature to compare clinical outcomes in patients undergoing left-sided valve procedures either with or without tricuspid valve repair surgery. Methods We performed a literature search using MEDLINE, EMBASE, Scopus and Web of Science. We identified articles to evaluate primary outcomes of both, cardiac and overall mortality. Secondary outcomes included stroke, wound infection, reoperation, new-onset atrial fibrillation, renal failure, duration of intensive care stay and permanent pacemaker implantation. All analysis was done using the random effects model. Results A total of 36 studies were included with 76,249 patients. There was significant reduction in cardiac mortality (p < 0.0001) with concomitant tricuspid valve repair despite higher CPB (p < 0.00001) and X-Clamp times (p < 0.00001). There was no significant difference in overall mortality. There was significantly lower postoperative tricuspid regurgitation (p < 0.00001) with concomitant tricuspid repair. There were no differences in postoperative stroke, wound infection, atrial fibrillation, renal failure, and intensive care unit duration of stay between the two groups. Conclusions Concomitant tricuspid valve surgery for moderate tricuspid regurgitation during left-sided valve surgery offers improved survival benefit due to significant decrease in cardiac mortality. Additionally, this strategy results in significant decrease in late tricuspid regurgitation with no increase in morbidity. |
| format | Article |
| id | doaj-art-aa91e3cabe744a45bcecc9aca9936e23 |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-aa91e3cabe744a45bcecc9aca9936e232025-08-20T03:46:27ZengBMCJournal of Cardiothoracic Surgery1749-80902025-07-0120111810.1186/s13019-025-03464-0Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysisAnupama Barua0Nicholas Wong1Shubham Jain2Mohsin Uzzaman3Prakash Nanjaiah4Ravish Jeeji5Lognathen Balacumaraswami6Department of Cardiothoracic Surgery &, Royal Stoke University Hospital, University Hospital North Midlands, NHS TrustDepartment of Cardiothoracic Surgery &, Royal Stoke University Hospital, University Hospital North Midlands, NHS TrustDepartment of Cardiothoracic Surgery &, Royal Stoke University Hospital, University Hospital North Midlands, NHS TrustDepartment of Cardiothoracic Surgery &, Royal Stoke University Hospital, University Hospital North Midlands, NHS TrustDepartment of Cardiothoracic Surgery &, Royal Stoke University Hospital, University Hospital North Midlands, NHS TrustDepartment of Cardiac Anaesthesia and Intensive Care, Royal Stoke University Hospital, University Hospital North MidlandsDepartment of Cardiothoracic Surgery &, Royal Stoke University Hospital, University Hospital North Midlands, NHS TrustAbstract Objectives There is controversy over the optimal management of moderate tricuspid valve regurgitation during left-sided valve surgery due to the paucity of robust evidence for enhanced outcomes from concomitant tricuspid valve repair. Hence, we assessed the literature to compare clinical outcomes in patients undergoing left-sided valve procedures either with or without tricuspid valve repair surgery. Methods We performed a literature search using MEDLINE, EMBASE, Scopus and Web of Science. We identified articles to evaluate primary outcomes of both, cardiac and overall mortality. Secondary outcomes included stroke, wound infection, reoperation, new-onset atrial fibrillation, renal failure, duration of intensive care stay and permanent pacemaker implantation. All analysis was done using the random effects model. Results A total of 36 studies were included with 76,249 patients. There was significant reduction in cardiac mortality (p < 0.0001) with concomitant tricuspid valve repair despite higher CPB (p < 0.00001) and X-Clamp times (p < 0.00001). There was no significant difference in overall mortality. There was significantly lower postoperative tricuspid regurgitation (p < 0.00001) with concomitant tricuspid repair. There were no differences in postoperative stroke, wound infection, atrial fibrillation, renal failure, and intensive care unit duration of stay between the two groups. Conclusions Concomitant tricuspid valve surgery for moderate tricuspid regurgitation during left-sided valve surgery offers improved survival benefit due to significant decrease in cardiac mortality. Additionally, this strategy results in significant decrease in late tricuspid regurgitation with no increase in morbidity.https://doi.org/10.1186/s13019-025-03464-0Concomitant tricuspid surgeryTricuspid valve regurgitation |
| spellingShingle | Anupama Barua Nicholas Wong Shubham Jain Mohsin Uzzaman Prakash Nanjaiah Ravish Jeeji Lognathen Balacumaraswami Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysis Journal of Cardiothoracic Surgery Concomitant tricuspid surgery Tricuspid valve regurgitation |
| title | Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysis |
| title_full | Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysis |
| title_fullStr | Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysis |
| title_full_unstemmed | Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysis |
| title_short | Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery – a meta-analysis |
| title_sort | concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left sided valve surgery a meta analysis |
| topic | Concomitant tricuspid surgery Tricuspid valve regurgitation |
| url | https://doi.org/10.1186/s13019-025-03464-0 |
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