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The following is a summary of “Long-term outcomes with medical therapy, transcatheter repair, or surgery for isolated tricuspid regurgitation: a systematic review and network meta-analysis,” published in the December 2024 issue of Cardiology by Saito et al.    

Several devices for transcatheter tricuspid valve (TV) repair have emerged to treat tricuspid regurgitation (TR). Few studies have compared transcatheter repair to medical therapy (MT) or isolated surgical repair.  

Researchers conducted a retrospective study comparing long-term mortality and periprocedural outcomes of MT, transcatheter TV repair, and surgical TV repair or replacement in individuals with TR.  

They searched PubMed and EMBASE (February 2024) for studies comparing MT, surgical TV repair, surgical TV replacement, or transcatheter TV repair. The primary outcome was long-term mortality (≥ 1 year), and secondary outcomes included short-term mortality (30-day or in-hospital mortality) and periprocedural complications. A network meta-analysis using a random effects model was performed.  

The results showed that MT alone was associated with higher long-term mortality compared to surgical TV repair (HR [95% CI] 1.72 [1.34–2.23]), surgical TV replacement (HR [95% CI] 1.49 [1.14–1.96]), and transcatheter TV repair (HR [95% CI] 1.52 [1.30–1.78]). Long-term mortality was similar between transcatheter and surgical interventions. Transcatheter TV repair had a lower risk of short-term mortality compared to surgical TV repair (RR [95% CI] 0.40 [0.22–0.72]) and surgical TV replacement (RR [95% CI] 0.35 [0.19–0.66]), fewer periprocedural complications, including new pacemaker implantation, renal complications, and cardiogenic shock, than surgical interventions were also included.  

They concluded that transcatheter TV repair offered similar long-term outcomes to surgery, making a promising treatment option for individuals with TR.  

Source: link.springer.com/article/10.1007/s00392-024-02579-z