AUTHOR=Sannino Anna , Ilardi Federica , Hahn Rebecca T. , Lancellotti Patrizio , Lurz Philipp , Smith Robert L. , Esposito Giovanni , Grayburn Paul A. 

TITLE=Clinical and Echocardiographic Outcomes of Transcatheter Tricuspid Valve Interventions: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.919395

DOI=10.3389/fcvm.2022.919395

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Medically managed tricuspid regurgitation (TR) has detrimental outcomes. Transcatheter tricuspid valve interventions (TTVIs) represent an alternative to surgery in high-risk patients; however, only early experiences exist.</p></sec><sec><title>Aim</title><p>The aim of this study was to analyze the clinical and echocardiographic outcomes of TTVI.</p></sec><sec><title>Methods</title><p>MEDLINE, ISI Web of Science, and SCOPUS databases were searched for studies published up to June 2021. Studies reporting data on outcome post-TTVIs were included. This study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements. The primary endpoint was all-cause mortality at 30-day and 1-year post-TTVI.</p></sec><sec><title>Results</title><p>Out of 2,718 studies, 27 were included. Notably, 30-day and 1-year all-cause mortalities were 5% (95% confidence interval [CI]: 4–8%, <italic>p</italic> &lt; 0.001) and 25% (95% CI: 12–45%, <italic>p</italic> = 0.016). Procedural success was associated with a 58% risk reduction in 1-year mortality vs. lack thereof (odds ratio 0.42, 95% CI: 0.27–0.66, <italic>p</italic> &lt; 0.001). TTVI is associated with a significant reduction in TR severity (TR EROA, mean difference [MD] 0.31 cm<sup>2</sup>; 95% CI: 0.23–0.39 cm<sup>2</sup>, <italic>p</italic> &lt; 0.001; regurgitant volume, MD 23.54 ml; 95% CI: 17.4–29.68 ml, <italic>p</italic> = 0.03) and increase in forward stroke volume (FSV, MD 3.98 ml; 95% CI: 0.11–7.86 ml, <italic>p</italic> = 0.04).</p></sec><sec><title>Conclusion</title><p>TTVI significantly reduces TR severity and increases FSV and is associated with improved survival at 1 year compared with patients without procedural success. Long-term outcomes compared with medical therapy await the results of ongoing pivotal trials; nonetheless, TTVIs appear to be a promising alternative to surgery for TR.</p></sec>