Cardiovascular Surgery and Interventions 2024, Vol 11, Num 1 Page(s): 001-009
A meta-analysis of beating versus arrested heart isolated tricuspid valve surgery

Zihni Mert Duman1, Muhammed Bayram2, Emre Yaşar2, Barış Timur3, Adem Reyhancan4, Davut Azboy1, Sefa Şenol1, Burak Onan2

1Department of Cardiovascular Surgery, Elazığ City Hospital, Elazığ, Türkiye
2Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Cardivascular Surgery Hospital, Istanbul, Türkiye
3Department of Cardiovascular Surgery, Siyami Ersek Cardiovascular Surgery Hospital, Istanbul, Türkiye
4Department of Cardiovascular Surgery, Medicine Faculty of Trakya University, Edirne, Türkiye

Keywords: Arrested heart, beating heart, surgery, tricuspid valve
Objectives: This meta-analysis aimed to compare postoperative outcomes of isolated tricuspid valve surgery with the beating heart and arrested heart techniques.

Materials and methods: A meta-analysis of published studies reporting the comparison of early and late follow-up of isolated tricuspid valve surgery with beating heart and arrested heart techniques was conducted. An analysis of the studies was also performed for each postoperative outcome, observed mortality, and reintervention.

Results: A total of 459 articles were identified. After the removal of duplicate and irrelevant studies and the exclusion of studies due to combined procedures, study design, and the lack of relevant outcomes, five retrospective observational studies with 566 patients were included for meta-analysis. The beating heart technique was used in 303 patients, whereas 263 underwent the arrested heart technique for isolated tricuspid valve surgery. Patients who underwent beating heart surgery had a higher EuroSCORE (European System for Cardiac Operative Risk Evaluation) II (mean difference=6.02, 95% confidence interval [CI]: 2.87-9.16, p=0.0002). No significant differences were observed in in-hospital mortality (odds ratio [OR]=0.96, 95% CI: 0.53-1.73, p=0.88) and permanent pacemaker implantation rate (OR=0.84, 95% CI: 0.49-1.46, p=0.54). Previous cardiac surgery (OR=2.87, 95% CI: 2.03-4.04, p<0.0001) was significantly higher, and infective endocarditis (OR=0.4, 95% CI: 0.26-0.60, p<0.0001) was significantly less in the beating heart group.

Conclusion: Isolated tricuspid valve surgery using the beating heart and arrested heart technique can be performed with no significant difference in postoperative morbidities and mortality. The beating heart technique may be used in more complex patients.

DOI : 10.5606/e-cvsi.2024.1535