{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:03Z","timestamp":1787018103070,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,12,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Tricuspid regurgitation (TR) is a common finding in adults with congenital heart disease referred for pulmonary valve replacement (PVR). However, indications for combined valve surgery remain controversial. This study aimed to evaluate early results of concomitant tricuspid valve intervention (TVI) at the time of PVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Observational studies comparing TVI+PVR and isolated PVR were identified by a systematic search of published research. Random\u2010effects meta\u2010analysis was performed, comparing outcomes between the 2 groups. Six studies involving 749 patients (TVI+PVR, 278 patients; PVR, 471 patients) met the eligibility criteria. In the pooled analysis, both TVI+PVR and PVR reduced TR grade, pulmonary regurgitation grade, right ventricular end\u2010diastolic volume, and right ventricular end\u2010systolic volumes. TVI+PVR, but not PVR, was associated with a decrease in tricuspid valve annulus size (mean difference, \u22126.43\u00a0mm, 95% CI, \u221210.59 to \u22122.27;\n                      <jats:italic>P<\/jats:italic>\n                      =0.010). Furthermore, TVI+PVR was associated with a larger reduction in TR grade compared with PVR (mean difference, \u22120.40; 95% CI, \u22120.75 to \u22120.05;\n                      <jats:italic>P<\/jats:italic>\n                      =0.031). No evidence could be established for an effect of either treatment on right ventricular ejection fraction or echocardiographic assessment of right ventricular dilatation and dysfunction. There was no evidence for a difference in hospital mortality or reoperation for TR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">While both strategies are effective in reducing TR and right ventricular volumes, routine TVI+PVR can reduce TR grade to a larger extent than isolated PVR. Further studies are needed to identify the subgroups of patients who might benefit most from combined valve surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.022909","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T07:03:24Z","timestamp":1638860604000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Tricuspid Valve Intervention at the Time of Pulmonary Valve Replacement in Adults With Congenital Heart Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5606-376X","authenticated-orcid":false,"given":"Jef","family":"Van den Eynde","sequence":"first","affiliation":[{"name":"Helen B. Taussig Heart CenterThe Johns Hopkins Hospital and School of Medicine Baltimore MD"},{"name":"Department of Cardiovascular Sciences Department of Cardiovascular Diseases KU Leuven, University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connor P.","family":"Callahan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery The Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3175-3764","authenticated-orcid":false,"given":"Mauro","family":"Lo Rito","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato San Donato Milanese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6572-0090","authenticated-orcid":false,"given":"Nabil","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery Yorkshire Heart CentreLeeds General Infirmary England United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1424-8472","authenticated-orcid":false,"given":"Horacio","family":"Carvajal","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiothoracic Surgery Department of Surgery Washington University School of Medicine in St. Louis\/St. Louis Children\u2019s Hospital Saint Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5495-6919","authenticated-orcid":false,"given":"Alvise","family":"Guariento","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery The Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of EssenUniversity Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Weymann","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of EssenUniversity Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5850-5413","authenticated-orcid":false,"given":"Werner","family":"Budts","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences Congenital and Structural Cardiology Catholic University Leuven, University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4595-5922","authenticated-orcid":false,"given":"Marc","family":"Gewillig","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-2996","authenticated-orcid":false,"given":"Michel Pompeu","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Lankenau Heart InstituteMain Line Health Wynnewood PA"},{"name":"Department of Cardiac Surgery Research Lankenau Institute for Medical ResearchMain Line Health Wynnewood PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9428-0979","authenticated-orcid":false,"given":"Shelby","family":"Kutty","sequence":"additional","affiliation":[{"name":"Helen B. 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