Mechanical Versus Bioprosthetic Valve Replacement in the Tricuspid Valve Position: A Systematic Review and Meta-Analysis

Negm, Sherif; Arafat, Amr A.; Elatafy, Elatafy E.; Fawzy, Hosam

doi:10.1016/j.hlc.2020.03.011

Cited by 19 publications

(13 citation statements)

References 33 publications

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“…Furthermore, no significant differences were observed between the mechanical and biological groups in the 30 days and late mortality, reoperation, and 5-year valve failure. 21 Another study also determined that biological and mechanical valves were used in 76.2% and 23.8% of patients, respectively, and there were no significant hemodynamic differences between these two types of valves. 22 Similarly, Cho et al 23 evaluated that among 104 patients who underwent tricuspid valve replacement, 59 had mechanical and 45 had a biological valve replacement.…”

Section: Discussionmentioning

confidence: 98%

A comparative study on the results of beating and arrested heart isolated tricuspid valve surgery: A cross‐sectional study

Bigdelu

Azari

Mashayekhi

et al. 2022

Health Science Reports

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Background and Aims: The isolated tricuspid valve surgery is performed using beating or arrested heart surgery. The present study aimed to evaluate and compare the results of patients who underwent isolated tricuspid valve surgery using the beating and arrested heart techniques. Methods:In this retrospective observational study, all patients undergoing isolated tricuspid valve surgery between 2011 and 2018 were included. The patient's demographic information, echocardiographic, surgery, and hospitalization results were collected, and the EuroSCORE was calculated from the patient's medical records.Results: Fifty-three patients were included in the study of which 21 (39.63%) and 32 (60.37%) underwent a beating heart and arrested heart surgeries, respectively. There were no significant differences between the two studied groups in the echocardiographic results before and after the surgery, total hospitalization days (p = 0.56), and the mortality in the first 30 days after the surgery (p = 0.152). However, the duration of surgery (p < 0.001), EuroSCORE (p = 0.005), and patients who underwent lateral thoracotomy (p = 0.007) were notably lower in the arrested heart than in the beating heart group. In contrast, the duration of cardiopulmonary bypass and hospitalization in an intensive care unit after the surgery was remarkably lower in the beating heart than in the arrested heart group (p < 0.001 for both cases). Conclusion:Although there were some significant differences between the two kinds of surgery techniques, it seems superficial that made a particular decision to consider each method's superiority. Therefore, further studies with larger populations and meta-analyses are required to recommend the preferred method for the surgeons certainly.

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Section: Discussionmentioning

confidence: 98%

A comparative study on the results of beating and arrested heart isolated tricuspid valve surgery: A cross‐sectional study

Bigdelu

Azari

Mashayekhi

et al. 2022

Health Science Reports

View full text Add to dashboard Cite

show abstract

“…A principal desvantagem das VCM ocorre devido ao elevado contato com o fluxo sanguíneo ao seu redor, que pode resultar na ativação das plaquetas, evidenciando um maior risco de trombose na superfície da válvula e um risco subsequente para embolia. Devido a este fator, todos os pacientes possuintes de válvulas mecânicas requerem anticoagulação de longo prazo, sendo utilizado de maneira geral um antagonista da vitamina K, como a varfarina (NEGM et al, 2021).…”

Section: Revisão Bibliográficaunclassified

“…Ademais, como grande desvantagem apresentada, o uso desse tipo de tecido introduz a possibilidade de maior desgaste e degeneração da válvula quando comparada à sua "concorrente" mecânica, denotando um grande fator motivador para a recusa desse método pelos pacientes (HEAD; CELIK; KAPPETEIN, 2017). Contudo, o processo de decidir qual tipo de VCB é melhor para um paciente é estritamente individual e está além das vantagens e desvantagens inespecíficas, sendo prioritariamente considerado o contexto específico, como os fatores de risco do indivíduo (NEGM et al, 2021).…”

Section: Revisão Bibliográficaunclassified

Implantação de prótese na insuficiência valvar cardíaca: mecânica ou biológica / Implantation of prosthesis in valvular heart disease: mechanical or biological

Floriano¹,

LIMA²,

Guerino³

et al. 2021

Braz. J. Hea. Rev.

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Este artigo buscou analisar as próteses valvares biológicas e mecânicas por meio de comparações associadas às suas diferentes durabilidades, riscos de desenvolver endocardite, tromboembolismo, eventos hemorrágicos, necessidade de reoperações e sobrevida a longo prazo, além da relação de custo e benefício de cada tipo de prótese valvar. As válvulas cardíacas mecânicas possuem como principal vantagem sua longa durabilidade, apresentando um número reduzido de reoperação comparadas as válvulas cardíacas biológicas, que sofrem desgaste maior com o tempo. O grande destaque recebido pelas válvulas cardíacas biológicas é relacionado a sua independência de medicamentos, algo que se apresenta como obstáculo pelas válvulas mecânicas devido à necessidade do uso de anticoagulante de forma vitalícia, ocasionado pela alta probabilidade de desenvolvimento de trombose na região valvar e, consequentemente, embolia, eventos que não ocorrem nas valvas biológicas. A eleição do tipo de prótese valvar deve ser feita de acordo com o perfil de cada paciente, levando em consideração suas individualidades, como idade, comorbidades, riscos de reoperação e sobrevida após operação, com a finalidade de promover um melhor prognóstico e qualidade de vida para esse grupo.

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“…In tricuspid valve position, mechanical valve prostheses have a higher risk of thrombosis than biological prostheses, but no differences between both emerged with respect to prosthetic valve failure, bleeding, reoperation, early mortality, and long-term survival. Negm et al 12 found an equal risk of 30-day and late mortality, reoperation, and 5-year valve failure in patients with mechanical versus biological TVR. The choice of the prosthesis in the tricuspid position should depend mainly on the patient's age, valve disease, and risk factors because of nonsuperiority of one over the other.…”

mentioning

confidence: 99%

Shedding some light on tricuspid intervention

Fattouch

Moscarelli²

2021

Journal of Cardiac Surgery

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Background: More than 1.6 million Americans have at least moderate to severe valvular tricuspid regurgitation, yet fewer than 8000 tricuspid valve operations are performed annually in the USA. The undertreatment for isolated tricuspid regurgitation might be related to the fact that in the past years no clear guidelines on 'how' and 'when' to treat tricuspid regurgitation were issued.Aims: Sarris-Michopoulos and colleagues carried out a meta-analysis with the aim to investigate the role of tricuspid valve repair versus tricuspid valve replacement in patients with isolated tricuspid valve regurgitation.Material and Methods: Outcomes of patients with first-time surgery for isolated tricuspid valve regurgitation without previous left-sided valve surgery were reviewed. Ten studies were included with a total of 1407 patients.Results: Authors concluded that patients who underwent tricuspid valve repair showed less 30-days mortality than replacement along with a reduced need for postoperaitve permanent pacemaker implantation rate.Discussion: Decision on whether to treat or not tricuspid valve is demanding, particularly in the context of the newest percutaneous technologies. Before intervention, careful evaluation of both tricuspid valve and right ventricle must be performed.Nevertheless, intervention, should not be deferred when clinically indicated. Conclusions:The findings form this meta-analysis suggest that reparative surgery, perhaps in an early stage, may be beneficial in selected cohort of patients.

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Mechanical Versus Bioprosthetic Valve Replacement in the Tricuspid Valve Position: A Systematic Review and Meta-Analysis

Cited by 19 publications

References 33 publications

A comparative study on the results of beating and arrested heart isolated tricuspid valve surgery: A cross‐sectional study

A comparative study on the results of beating and arrested heart isolated tricuspid valve surgery: A cross‐sectional study

Implantação de prótese na insuficiência valvar cardíaca: mecânica ou biológica / Implantation of prosthesis in valvular heart disease: mechanical or biological

Shedding some light on tricuspid intervention

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