{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T23:49:51Z","timestamp":1784850591333,"version":"3.55.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T00:00:00Z","timestamp":1552003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The surgical management of tricuspid regurgitation (TR) at the time of mitral valve surgery remains controversial. Our objectives were to determine the safety and efficacy of tricuspid valve (TV) repair during mitral valve surgery in a meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>MEDLINE and EMBASE were searched from 1946 to 2017 for all studies comparing TV repair to no intervention at the time of mitral valve surgery on early and late mortality and late TR. A random-effects meta-analysis of all outcomes was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>One thousand four hundred and seventeen studies were retrieved and a total of 17 studies [2 randomized clinical trial (n\u2009=\u2009211), 11 adjusted observational studies (n\u2009=\u20093848) and 4 unadjusted observational studies (n\u2009=\u200967\u00a0010)] that compared TV repair (n\u2009=\u200911\u00a0787) to no intervention (n\u2009=\u200956\u00a0027) at a mean follow-up of 6.0\u2009\u00b1\u20090.64\u2009years were included. There was no difference in 30-day\/in-hospital mortality between repair and no repair [risk ratio (RR) 1.19, 95% confidence interval (95% CI) 0.70\u20132.02; P\u2009=\u20090.52]. The incidence of new permanent pacemaker implantation was higher in the TV repair group (RR 2.73, 95% CI 2.57\u20132.89; P\u2009&lt;\u20090.01). TV repair was protective against late moderate or greater TR [incident rate ratio (IRR) 0.28, 95% CI 0.17\u20130.47; P\u2009&lt;\u20090.01] and severe TR (IRR 0.38, 95% CI 0.17\u20130.84). There was a numerically lower rate of late TV reoperation (IRR 0.39, 95% CI 0.12\u20131.25; P\u2009=\u20090.11) that did not reach statistical significance. Overall, there was no difference in late mortality between the 2 treatments (IRR 0.87, 95% CI 0.63\u20131.24; P\u2009=\u20090.43).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>TV repair appears safe in the perioperative period and may reduce future recurrent TR without any survival benefit.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivz036","type":"journal-article","created":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T23:20:55Z","timestamp":1550445655000},"page":"193-200","source":"Crossref","is-referenced-by-count":19,"title":["Tricuspid valve intervention at the time of mitral valve surgery: a meta-analysis"],"prefix":"10.1093","volume":"29","author":[{"given":"Derrick Y","family":"Tam","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Tran","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amine","family":"Mazine","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert H L","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mount Sinai Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario F L","family":"Gaudino","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio M","family":"Calafiore","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease, John Paul II Foundation, Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan O","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Department of Critical Care and Medicine, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E","family":"Fremes","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,8]]},"reference":[{"key":"2019072505401343100_ivz036-B1","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.jtcvs.2015.08.048","article-title":"Is the air in Toronto, Rochester, and Cleveland different from that in London, Monaco, Leiden, Genk, Milan, and New York?","volume":"150","author":"Dion","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2019072505401343100_ivz036-B2","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.jtcvs.2012.07.096","article-title":"Isolated tricuspid valve surgery in patients with previous cardiac surgery","volume":"146","author":"Pfannm\u00fcller","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2019072505401343100_ivz036-B3","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.athoracsur.2012.08.058","article-title":"The risk and outcomes of reoperative tricuspid valve surgery","volume":"95","author":"Jeganathan","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2019072505401343100_ivz036-B4","first-page":"e521","article-title":"2014 AHA\/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","author":"Nishimura","year":"2014","journal-title":"Circulation"},{"key":"2019072505401343100_ivz036-B5","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"2019072505401343100_ivz036-B6","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.jclinepi.2010.07.017","article-title":"GRADE guidelines: 4. 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