Outcomes of Mild to Moderate Functional Tricuspid Regurgitation in Patients Undergoing Mitral Valve Operations: A Meta-Analysis of 2,488 Patients Ibrahim.

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Outcomes of Mild to Moderate Functional Tricuspid Regurgitation in Patients Undergoing Mitral Valve Operations: A Meta-Analysis of 2,488 Patients Ibrahim Kara, MD, Cengiz Koksal, MD, Alper Erkin, MD, Hakan Sacli, MD, Mucahit Demirtas, MD, Bilal Percin, MD, Mevriye Serpil Diler, MD, Kaan Kirali, MD The Annals of Thoracic Surgery Volume 100, Issue 6, Pages 2398-2407 (December 2015) DOI: 10.1016/j.athoracsur.2015.07.024 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Flow diagram shows the study selection process. The Annals of Thoracic Surgery 2015 100, 2398-2407DOI: (10.1016/j.athoracsur.2015.07.024) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Forest plots show the effect of tricuspid valve annuloplasty (TVA) vs no TVA for patients with mild to moderate functional tricuspid regurgitation (FTR) during mitral valve operations: freedom from (A) moderate to severe FTR, (B) death, and (C) tricuspid valve reoperation. The solid squares indicate the mean difference and are proportional to the weights used in the meta-analysis. The solid vertical line indicates no effect. The horizontal lines represent the 95% confidence intervals (CIs). The diamond indicates the weighted mean difference, and the lateral tips of the diamond indicate the associated 95% CI. The Annals of Thoracic Surgery 2015 100, 2398-2407DOI: (10.1016/j.athoracsur.2015.07.024) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Forrest plots show the effect of (A) tricuspid valve annuloplasty and (B) maze procedure in progression to moderate to severe functional tricuspid regurgitation (FTR). The solid squares indicate the mean difference and are proportional to the weights used in the meta-analysis. The solid vertical line indicates no effect. The horizontal lines represent the 95% confidence intervals (CIs). The diamond indicates the weighted mean difference, and the lateral tips of the diamond indicate the associated 95% CI. The Annals of Thoracic Surgery 2015 100, 2398-2407DOI: (10.1016/j.athoracsur.2015.07.024) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Meta-analysis for the progression of mild to moderate “‘untouched”’ tricuspid regurgitation in 1,266 patients who underwent mitral valve operations. The solid squares indicate the mean difference and are proportional to the weights used in the meta-analysis. The solid vertical line indicates no effect. The horizontal lines represent the 95% confidence intervals (CIs). The diamond indicates the weighted mean difference, and the lateral tips of the diamond indicate the associated 95% CI. The Annals of Thoracic Surgery 2015 100, 2398-2407DOI: (10.1016/j.athoracsur.2015.07.024) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Funnel plot shows publication bias analysis for (A) the primary end point and for (B) the secondary end point. The Annals of Thoracic Surgery 2015 100, 2398-2407DOI: (10.1016/j.athoracsur.2015.07.024) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Meta-regression analysis for (A) follow-up time, (B) quality of the study, (C) ethnicity, and (D) study design on the logit event rate. The Annals of Thoracic Surgery 2015 100, 2398-2407DOI: (10.1016/j.athoracsur.2015.07.024) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions