Concomitant tricuspid valve surgery in patients undergoing left ventricular assist device: a systematic review and meta-analysis

作者全名：Luo, Yuxiang; Leng, Jiajie; Shi, Rui; Jiang, Yingjiu; Chen, Dan; Wu, Qingchen; Tie, Hongtao

作者地址：[Luo, Yuxiang; Leng, Jiajie; Jiang, Yingjiu; Chen, Dan; Wu, Qingchen; Tie, Hongtao] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing, Peoples R China; [Shi, Rui] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Crit Care Med, Guangzhou, Guangdong, Peoples R China

通信作者：Wu, QC; Tie, HT (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing, Peoples R China.

来源：INTERNATIONAL JOURNAL OF SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001223156300067

JCR分区：Q1

影响因子：12.5

年份：2024

卷号：110

期号：5

开始页：3039

结束页：3049

文献类型：Article

关键词：left ventricular assist device; meta-analysis; right heart failure; systematic review; tricuspid valve surgery

摘要：Introduction:This study aims to investigate the effect of concomitant tricuspid valve surgery (TVS) during left ventricular assist device (LVAD) implantation due to the controversy over the clinical outcomes of concomitant TVS in patients undergoing LVAD. Methods:A systematic literature search was performed in PubMed and EMbase from the inception to 1 August 2023. Studies comparing outcomes in adult patients undergoing concomitant TVS during LVAD implantation (TVS group) and those who did not (no-TVS group) were included. The primary outcomes were right heart failure (RHF), right ventricular assist device (RVAD) implantation, and early mortality. All meta-analyses were performed using random-effects models, and a two-tailed P<0.05 was considered significant. Results:Twenty-one studies were included, and 16 of them were involved in the meta-analysis, with 660 patients in the TVS group and 1291 in the no-TVS group. Patients in the TVS group suffered from increased risks of RHF [risk ratios (RR)=1.31, 95% CI: 1.01-1.70, P=0.04; I 2=38%, p H =0.13), RVAD implantation (RR=1.56, 95% CI: 1.16-2.11, P=0.003; I 2=0%, p H =0.74), and early mortality (RR=1.61, 95% CI: 1.07-2.42, P=0.02; I 2=0%, p H =0.75). Besides, the increased risk of RHF holds true in patients with moderate to severe tricuspid regurgitation (RR=1.36, 95% CI: 1.04-1.78, P=0.02). TVS was associated with a prolonged cardiopulmonary bypass time. No significant differences in acute kidney injury, reoperation requirement, hospital length of stay, or ICU stay were observed. Conclusions:Concomitant TVS failed to show benefits in patients undergoing LVAD, and it was associated with increased risks of RHF, RVAD implantation, and early mortality.

基金机构：National Natural Science Foundation of China [81700602]; First-class Discipline Construction Project of First Clinical College, Chongqing Medical University [CYYY-BSHPYXM-2022-08]; Natural Science Foundation of Chongqing, China [CSTB2022NSCQ-MSX0840]; CQMU Program for Youth Innovation in Future Medicine [W0153]; First Affiliated Hospital of CQMU Young Outstanding Scientific and Technological Talents Program [ZYRC2022-04]; Senior Medical Talents Program of Chongqing for Young and Middle-aged [2023-56]

基金资助正文：This work was supported by the National Natural Science Foundation of China (No. 81700602), the First-class Discipline Construction Project of First Clinical College, Chongqing Medical University (No. CYYY-BSHPYXM-2022-08), and Natural Science Foundation of Chongqing, China (No. CSTB2022NSCQ-MSX0840), CQMU Program for Youth Innovation in Future Medicine (W0153), the First Affiliated Hospital of CQMU Young Outstanding Scientific and Technological Talents Program(ZYRC2022-04), and Senior Medical Talents Program of Chongqing for Young and Middle-aged (2023-56).