Meta-Analysis of Clinical Outcomes of Tricuspid Valve Replacement

Abstract

AbstractBackground: The long-term results of Tricuspid Valve Replacement (TVR) depend on factors related to the original valve disease more than on the prosthesis type. Tricuspid valve prosthesis; either mechanical or bioprosthetic, should be chosen according to the individual patient's characteristics.Aim of Study: The aim of the study was to analyze the clinical results of tricuspid valve replacement, comparing the different types of tricuspid valve prostheses.Patients and Methods: A meta-analysis study was done to evaluate TVR results in adults in the literature published in the period of 20 years “1995: 2015”, focusing on literature published in English comparing mechanical valves to bio-prosthetic valves. We performed a search over published literature of different databases “Embase, PubMed, Ovid, Justor, Science Direct, and Wiley Blackwell.”Results: The total of 17 studies evaluating 1020 mechanical valve and 1199 bioprosthetic valve patients were included in the meta-analysis. Valve thromboses, and emboli are less reported with bioprosthetic valve (RR=6.52; 95% CI: 3.00, 14. 15; p<0.00001) and (RR=2.25; 95% CI: 1.14, 4.46; p= 0.02) respectively. There was no statistically significant difference between valve types as regards to bleeding, heart block, low cardiac output, valve failure, infective endocarditis, stroke, and renal failure.Conclusion: The type of the tricuspid valve prosthesis should be chosen based on patient's characteristics but occa-sionally it's equivocal, that's when the bioprosthetic valve should be preferred because of its less morbidity.