Abstract 4339719: Impact of Tricuspid Regurgitation Severity on Clinical Outcomes Following Mitral Valve Interventions: A Meta-Analysis

Bachground: Functional tricuspid regurgitation (TR) frequently develops secondary to mitral valve disease, but its impact on clinical outcomes after mitral valve interventions are not properly understood. The best management strategy for moderate to severe tricuspid regurgitation after mitral valve intervention still continues to be debated Hypothesis: We hypothesized that moderate to severe TR at baseline is associated with more mortality and adverse cardiovascular events following mitral valve intervention, regardless of intervention type, compared with none/mild TR Methods: We systematically searched PubMed, Embase, Google scholar for studies examining baseline TR severity impact on clinical outcomes, following Mitral valve interventions. Patients are stratified by baseline TR severity into Non-severe group(none/mild TR) and Severe group(moderate/severe TR). Inverse-variance weighting method was used and risk ratio’s along with their 95%CI was calculated by using Random effects model. All the analysis was done in R software version 4.5.0 Results: We included 3 studies with 5907 patients, who were divided into Non-severe and severe groups based on their baseline TR severity. Non-severe group demonstrated significantly less All cause mortality compared to severe group (RR= 0.29; 95%CI: 0.19, 0.45; p<0.0001). in-hospital stroke was significantly less in Non-severe group (RR= 0.44; 95%CI: 0.24, 0.80; p=0.0071) and risk of new onset in-hospital Atrial fibrillation was also significantly less in Non-severe group (RR= 0.79; 95%CI: 0.67, 0.93; p=0.004). Heterogeneity was negligible, indicating that outcomes were consistent across these studies. Conclusion: Moderate to severe TR independently showed increased risk of mortality and in-hospital risk of new onset Atrial fibrillations and stroke compared to none/mild TR in patients who underwent mitral valve interventions. These findings suggest that early identification and management of TR during mitral valve procedures are important and therefore TR severity should be a key consideration for procedural planning during mitral valve interventions.