Overview
Prosthetic tricuspid valve failure refers to the malfunction or deterioration of an artificial tricuspid valve, necessitating reintervention. The choice between mechanical and tissue prosthetic tricuspid valves involves a trade-off between long-term durability and the risk of complications like thromboembolism or structural valve degeneration.Management
Mechanical tricuspid valve replacement (TVR) is associated with a lower risk of death compared to tissue valves 1.
Mechanical TVR is linked to a longer lifetime gain, with restricted mean survival time being 2.2 years longer than with tissue valves 1.
The risk of reoperation for mechanical TVR is similar to tissue valves from 0 to 7 years post-implantation 1.
After 7 years, mechanical TVR has a significantly lower risk of reoperation compared to tissue valves 1.Key Recommendations
Mechanical tricuspid valve replacement is associated with a lower risk of death and improved long-term survival compared to tissue valves 1. (Evidence: Strong)
For patients requiring tricuspid valve replacement, mechanical valves should be considered due to their association with reduced mortality and increased lifetime gain 1. (Evidence: Strong)
The risk of reoperation is comparable between mechanical and tissue tricuspid valves within the first 7 years, but mechanical valves demonstrate a lower reoperation rate thereafter 1. (Evidence: Strong)References
1 Sá MP, Iyanna N, Tabrizi NS, Jacquemyn X, Ahmad D, Brown JA et al.. Long-Term Outcomes of Tricuspid Valve Replacement With Mechanical Versus Tissue Valves: Meta-Analysis of Reconstructed Time-to-Event Data. The American journal of cardiology 2024. link
2 Mollan RA, McClelland CJ. Instrumentation for the revision of total hip arthroplasty. Clinical orthopaedics and related research 1984. link