Abstract 4369882: Transcatheter Tricuspid Valve Intervention plus Optimized Medical Therapy versus Optimized Medical Therapy Alone in Tricuspid Regurgitation: A Systematic Review and Meta Analysis

Background: Tricuspid regurgitation (TR) disease has a high incidence and prevalence. and while optimized medical therapy (OMT) helps with symptoms, it may be inadequate in severe cases. Surgical options carry significant risks. Hence, less invasive Tricuspid Transcatheter Valve Interventions (TTVI) become suitable for TR treatment. In our meta analysis , we aimed to compare TTVI combined with OMT versus OMT alone. Methods: A systematic search was performed for three databases (PubMed, Scopus, and Web of Science) to identify any relevant studies comparing TTVI plus OMT versus OMT alone. The primary outcome was all-cause mortality. The Secondary outcome was heart failure (HF) hospitalization, and the combined outcome of all-cause mortality and heart failure hospitalization. We used hazard ratio (HR) for dichotomous outcomes. Results: Eight studies, five observational and three randomized controlled trilas (RCTs), with a total number of patients 4791 were included in our study. In the analysis, all-cause mortality was significantly lower with TTVI combined with OMT (HR 0.59, 95% CI: 0.44-0.78, P = 0.0002) over OMT alone. Furthermore, regarding HF hospitalization, the analysis favoured TTVI with OMT over OMT alone (HR 0.69, 95% CI: 0.49-0.96, P = 0.03). Conclusion: This study demonstrates that treatment with TTVI combined with OMT significantly reduces all-cause mortality and HF hospitalization compared to OMT alone.