Preoperative risk factors for residual tricuspid regurgitation after isolated left-sided valve surgery: a systematic review and meta-analysis.
OBJECTIVE
Residual tricuspid regurgitation (TR) that has developed after isolated left-sided valve surgery is not uncommon. Indications for concomitant tricuspid repair at the initial operation have not been well established. The selection of high-risk preoperative patients is of great importance in this situation.


METHODS
Six databases were searched to access eligible articles reporting potential risk factors for the development of residual TR. The pooled analysis of risk factors was based on odds ratios or mean differences with their 95% confidence intervals.


RESULTS
A total of 3,138 patients with 487 residual TR in 11 studies were analyzed. Of the 14 candidate parameters in our meta-analysis, 10 factors, i.e. older age, female gender, atrial fibrillation, rheumatic etiology, mitral valve surgery, previous valve surgery, a long time from onset to surgery, 2+/3+ TR and enlarged left and right atria, were found to be significantly associated with the development of residual TR.


CONCLUSIONS
Our study highlights the role of the above preoperative risk factors in the development of residual TR after isolated left-sided valve surgery and emphasizes the need of further studies to investigate other potential predictors. Moreover, predictive models or scoring systems for the identification of patients at a high risk for developing late TR are urgently needed.
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, PR China.
Tie-Yuan
TY
Zhu
Xin-Ping
XP
Min
Hai-Bo
HB
Zhang
Xu
X
Meng
D001021:Aortic Valve / Q000601:surgery; D001281:Atrial Fibrillation / Q000150:complications; D000082882:Bicuspid Aortic Valve Disease; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011300:Preoperative Care; D012214:Rheumatic Heart Disease / Q000150:complications; D012307:Risk Factors; D014262:Tricuspid Valve Insufficiency / Q000209:etiology*; D018487:Ventricular Dysfunction, Left / Q000150:complications