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The following is a summary of “Long-term outcomes of tricuspid valve replacement with mechanical versus tissue valves: meta-analysis of reconstructed time-to-event data,” published in the June 2024 issue of Cardiology by Sá et al.

Opting between mechanical and tissue valves for tricuspid valve replacement (TVR) has been difficult. 

Researchers conducted a retrospective study evaluating the long-term effects of types of valves on patient-relevant outcomes.

They performed a systematic review and analyzed reconstructed time-to-event data of studies published till March 15, 2024 (according to PRISMA). From this review, 21 studies met the eligibility criteria, consisting of 7,166 patients (mechanical: 2,495 patients, 34.8%).

The results showed that patients undergoing mechanical TVR had a lower risk of death (HR 0.77; 95% CI 0.70-0.84, P<0.001) and lived 2.2 years longer (12.4 years vs. 10.2 years, P<0.001), compared to those with tissue TVR. The reoperations risk analysis revealed that reoperation risk was similar from 0 to 7 years (HR 0.98; 95% CI 0.60-1.61, P=0.946). However, after 7 years, mechanical TVR had a lower risk of reoperation (HR 0.24; 95% CI 0.08-0.72, P=0.001). Meta-regression analysis revealed that atrial fibrillation influenced the link between mechanical valves and mortality; death risk HRs decreased in populations with more atrial fibrillation cases (P=0.018).

Investigators concluded that mechanical TVR, when feasible and patient-approved, offers better long-term survival and fewer reoperations.

Source: ajconline.org/article/S0002-9149(24)00436-3/abstract#%20