New Research Paper
Focus on Mitral and Tricuspid Valves
Clinical Outcomes Following Isolated Transcatheter Tricuspid Valve Repair: A Meta-Analysis and Meta-Regression Study

https://doi.org/10.1016/j.jcin.2021.08.050Get rights and content
Under an Elsevier user license
open archive

Abstract

Objectives

The aim of this study was to assess the pooled clinical and echocardiographic outcomes of different isolated transcatheter tricuspid valve repair (ITTVR) strategies for significant (moderate or greater) tricuspid regurgitation (TR).

Background

Significant TR is a common valvular heart disease worldwide.

Methods

Published research was systematically searched for studies evaluating the efficacy and safety of ITTVR for significant TR in adults. The primary outcomes were improvement in New York Heart Association (NYHA) functional class and 6-minute walking distance and the presence of severe or greater TR at the last available follow-up of each individual study. Random-effect meta-analysis was performed comparing outcomes before and after ITTVR.

Results

Fourteen studies with 771 patients were included. The mean age was 77 ± 8 years, and the mean European System for Cardiac Operative Risk Evaluation II score was 6.8% ± 5.4%. At a weighted mean follow-up of 212 days, 209 patients (35%) were in NYHA functional class III or IV compared with 586 patients (84%) at baseline (risk ratio: 0.23; 95% CI: 0.13-0.40; P < 0.001). Six-minute walking distance significantly improved from 237 ± 113 m to 294 ± 105 m (mean difference +50 m; 95% CI: +34 to +66 m; P < 0.001). One hundred forty-seven patients (24%) showed severe or greater TR after ITTVR compared with 616 (96%) at baseline (risk ratio: 0.29; 95% CI: 0.20-0.42; P < 0.001).

Conclusions

Patients undergoing ITTVR for significant TR experienced significant improvements in NYHA functional status and 6-minute walking distance and a significant reduction in TR severity at mid-term follow-up.

Key Words

transcatheter intervention
transcatheter tricuspid valve repair
tricuspid regurgitation
tricuspid valve
TTVR

Abbreviations and Acronyms

6MWD
6-minute walking distance
EROA
effective regurgitant orifice area
HF
heart failure
ITTVR
isolated transcatheter tricuspid valve repair
MD
mean difference
NYHA
New York Heart Association
PASP
pulmonary artery systolic pressure
RR
risk ratio
RV
right ventricular
TAPSE
tricuspid annular plane systolic excursion
TR
tricuspid regurgitation
TTVR
transcatheter tricuspid valve repair
TV
tricuspid valve

Cited by (0)

The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the Author Center.

Drs Bocchino and Angelini contributed equally to this work.