scholarly journals Tricuspid Valve Replacement: Mechanical or Biological Prostheses? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 24 (2) ◽  
pp. E209-E214
Author(s):  
Zeyi Cheng ◽  
Tingting Fang ◽  
Dandan Wang ◽  
Yingqiang Guo
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Prosthetic Valve ◽  
Meta Analysis ◽  
Early Mortality ◽  
Tricuspid Valve Replacement ◽  
Mechanical Prostheses ◽  
Significant Difference ◽  
Valve Position ◽  
Biological Prostheses

Background: Tricuspid valve replacement (TVR) is seldom performed in cardiac valve surgery, and there currently are no clinical guidelines as to which type of prostheses is better in tricuspid valve position. This meta-analysis was performed to compare the results of mechanical and biological prostheses for TVR. Methods: We searched the Pubmed, Cochrane, and Embase clinical trial databases to collect all related studies published from January 1, 2000 to July 31, 2020. A random-effects model was used to evaluate the odds ratios (OR) and its 95% confidence intervals (CI) of time-to-event related effects of the surgical procedures; every study’s quality was evaluated by the Newcastle-Ottawa Scale (NOS). Results: A total of 13 retrospective studies, including 1453 patients were analyzed. There were no statistically differences between mechanical and biological prostheses with respect to prosthetic valve failure [OR = 0.84, 95% CI(0.54, 1.28), P = .41], bleeding [OR = 0.84, 95% CI(0.54,1.28), P = .41], reoperation [OR = 1.02, 95% CI(0.58,1.78), P = .95], early mortality [OR = 1.35, 95% CI(0.82,2.25), P = .24] and long-time survival [OR = 1.09, 95% CI(0.70, 1.69), P = .70], but a significant difference can be seen in mechanical prostheses with a higher risk of thrombosis [OR = 0.17, 95% CI(0.05, 0.60), P = .006, I2 = 0%]. Conclusions: In tricuspid valve position, mechanical valve prostheses have a higher risk of thrombosis than biological prostheses, but no statistical differences between mechanical and biological prostheses with respect to prosthetic valve failure, bleeding, reoperation, early mortality, and long-term survival. The valve disease and patient’s age and risk factors are the most important considerations in the decision-making process. The more specific conclusion needs to be further proved by large-sample, multi-center, randomized, double-blind and control trials.

scholarly journals Which is the best prosthesis in an isolated or combined tricuspid valve replacement?

2020 ◽  
Vol 59 (1) ◽  
pp. 170-179
Author(s):  
Peng Liu ◽  
Dong-Sheng Xia ◽  
Wei-Hua Qiao ◽  
Dan Hu ◽  
Adnan Ahmed ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Optimal Choice ◽  
Long Term Results ◽  
Ebstein’S Anomaly ◽  
Tricuspid Valve Replacement ◽  
Ebstein's Anomaly ◽  
Significant Difference ◽  
Biological Prostheses

Abstract OBJECTIVES The debate concerning the optimal choice of tricuspid position continues. We compared the long-term results of mechanical and biological prostheses in patients who underwent isolated or combined tricuspid valve replacement, at 2 major cardiac surgical centres in central China. METHODS From January 1999 to December 2018, 338 patients underwent tricuspid valve replacement. Patients were divided into an isolated group or a combined group according to whether their surgery was combined with a left heart valve surgery. Mechanical tricuspid valve replacement was performed in 142 patients (isolated group: 41 vs combined group: 101), and 196 patients underwent bioprosthetic tricuspid valve replacement (isolated group: 145 vs combined group: 51). Operative results, long-term survival and tricuspid valve-related events were compared. RESULTS Early mortality in the combined group was higher (n = 6, 4%) than that in the isolated group (n = 3, 2%), but no significant difference was observed between the mechanical and biological subgroups. In the isolated group, there was a higher event-free rate in the biological subgroup than in the mechanical subgroup (P = 0.042) and a similar result was also observed for patients without Ebstein’s anomaly (P = 0.039). In the combined group, no significant difference was observed (P = 0.98). Survival rates were similar between the mechanical and biological subgroups in both the isolated (P = 0.54) and combined (P = 0.81) groups. Mechanical valves in isolated tricuspid valve replacement were more prone to valve thrombosis and bleeding. CONCLUSIONS Every decision regarding tricuspid valve prostheses should be individualized, but biological prostheses may be an optimal choice for patients, especially for patients without Ebstein’s anomaly, in isolated tricuspid valve replacement.

Tricuspid valve replacement: Porcine bioprostheses and mechanical prostheses

1995 ◽  
Vol 60 ◽  
pp. S470-S474 ◽  
Author(s):  
A. Ian Munro ◽  
W.R. Eric Jamieson ◽  
G. Frank ◽  
O. Tyers ◽  
Eva Germann
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Tricuspid Valve Replacement ◽  
Mechanical Prostheses

Long-term results of tricuspid valve replacement and the problem of prosthetic valve thrombosis

1983 ◽  
Vol 51 (7) ◽  
pp. 1128-1132 ◽  
Author(s):  
Charles W. Thorburn ◽  
John J. Morgan ◽  
Mark X. Shanahan ◽  
Victor P. Chang
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Prosthetic Valve ◽  
Long Term Results ◽  
Tricuspid Valve Replacement ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis

scholarly journals Tricuspid Valve Infective Endocarditis In Drug Abusers: Clinical Features and Results of Surgical Treatment

2013 ◽  
Vol 7 (1) ◽  
pp. 29-34
Author(s):  
DI Lashmanov ◽  
Krishna Bhandari ◽  
VA Chiginev ◽  
VV Pichugin ◽  
EN Zemskova
Keyword(s):  
Surgical Treatment ◽  
Drug Abuse ◽  
Infective Endocarditis ◽  
Valve Replacement ◽  
Clinical Features ◽  
Tricuspid Valve ◽  
Prosthetic Valve ◽  
Drug Abusers ◽  
Tricuspid Valve Replacement ◽  
Ultrasound Investigation

The objective of this study was to evaluate the clinical features, diagnostic criteria and indications for surgery in patients – drug abusers with tricuspid valve infective endocarditis (TVIE), and outcome of surgical treatment in these patients. From December 1999 to August 2009 35 patients (drug addicts) with TVIE were operated in the department of acquired heart diseases of Cardiac and Vascular Surgery Center, Nizhny Novgorod. 25 males and 10 females aged from 15 to 51 years were included in this study. 3 patients were re-operated due to recurrence of endocarditis. Biological prosthetic valve "Bio-Lab" was used in all patients. Intravenous drug abuse was the cause of the disease in all patients. Acute onset with hectic fever, shivering, profuse sweating, intoxication and development of multi-organ failure were the main clinical features of the disease. Embolism of the peripheral branches of pulmonary artery by septic embolus or micro thrombi were common symptoms. Ultrasound investigation played an important role in diagnosis of TVIE. It was the only criteria for the verification of the diagnosis in patients with fever of unknown origin until the appearance of valve damages and cardiac murmurs. All 35 (100%) patients underwent tricuspid valve replacement (TVR). 3 (8.57%) patients underwent redo TVR because of prosthetic valve endocarditis due to persistent intravenous drug abuse after surgery. The hospital mortality rate was 0%. Acute debut of the disease may be the first clinical feature of tricuspid valve infec­tive endocarditis in drug abusers. Ultrasound investigation is important for early diagnosis and effective treatment. Surgical treatment is indicated in cases of ineffective antibiotic therapy and massive tricuspid valve damages. Tricuspid valve replacement by a biological prosthesis was the treatment of choice in these patients. The use of biological prosthetic valve had good clinical re­sults with low thrombogenic risk and high resistance to infection. Nepalese Heart Journal | Volume 7 | No.1 | November 2010 (special issue) | Page 29-34 DOI: http://dx.doi.org/10.3126/njh.v7i1.8499

scholarly journals Meta-Analysis of Clinical Outcomes of Tricuspid Valve Replacement

2019 ◽  
Vol 87 (9) ◽  
pp. 2877-2883
Author(s):  
SHERIF NEGM, M.Sc.; AMR A. ARAFAT, M.D. ◽  
EL-ATAFY M. EL-ATAFY, M.D.; HOSAM F. FAWZY, M.D.
Keyword(s):  
Clinical Outcomes ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Meta Analysis ◽  
Tricuspid Valve Replacement

Tricuspid valve replacement: results comparing mechanical and biological prostheses

2000 ◽  
Vol 69 (4) ◽  
pp. 1295 ◽  
Author(s):  
Carlos Del Campo ◽  
Jon R Sherman
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Tricuspid Valve Replacement ◽  
Biological Prostheses

Should a Mechanical or Biological Prosthesis Be Used for a Tricuspid Valve Replacement? A Meta-Analysis

2016 ◽  
Vol 31 (5) ◽  
pp. 294-302 ◽  
Author(s):  
Peng Liu ◽  
Wei-Hua Qiao ◽  
Fu-Qiang Sun ◽  
Xin-Long Ruan ◽  
Mahmoud Al Shirbini ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Meta Analysis ◽  
Tricuspid Valve Replacement ◽  
Biological Prosthesis
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