Abstract 16039: Impact of Different Annuloplasty Methods for Tricuspid Regurgitation; a Network Meta-analysis

Abstract

Background: Although moderate-severe tricuspid valve regurgitation (TR) is an independent risk factor for progressive heart failure and increased mortality, the best method for tricuspid repair remains controversial. As such, we conducted a network meta-analysis to compare early and late outcomes for suture, flexible band, and rigid ring as tricuspid annuloplasty (TAP) in patients with TR. Methods: MEDLINE and EMBASE were searched through February 15th, 2020 to identify randomized controlled trials (RCTs) and observational trials that investigated early and late outcomes after TAP for TR. The outcomes of interest were perioperative mortality, long-term survival and TR recurrence. TR recurrence was defined as at least moderate (TR grade 2) on serial echocardiogram. Results: Our systematic literature search identified 2 RCTs and 16 observational trials, including 6,788 patients who underwent TAP. Median follow-up period was 1-7.4 year. There were no significant differences of perioperative and long-term all-cause mortality among three TAP methods. Suture TAP was associated with a significant increase in TR recurrence compared to rigid ring TAP (Hazard ratio, 2.31; 95% Confidence Interval, 1.40-3.80; p =0.001) (Figure). There were no significant differences were observed in other comparisons in TR recurrence. Conclusion: Our network meta-analysis demonstrated significant reduction in TR recurrence for rigid ring TAP compared to Suture TAP. However, there was no significant mortality difference among suture, flexible band, and rigid ring TAP.