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Outcomes in techniques of valve sparing aortic root replacement: A systematic review and meta-analysis.
Toh, Steven; Ang, Juliana; George, Joel Jacob; Jayawardena, Ovin; Mahbub, Samiha; Harky, Amer.
Afiliação
  • Toh S; School of Medicine, Faculty of Life Science, University of Liverpool, Liverpool, UK.
  • Ang J; School of Medicine, Faculty of Life Science, University of Liverpool, Liverpool, UK.
  • George JJ; School of Medicine, Faculty of Life Science, University of Liverpool, Liverpool, UK.
  • Jayawardena O; School of Medicine, Faculty of Life Science, University of Liverpool, Liverpool, UK.
  • Mahbub S; Department of Medicine, St. George's University of London, London, UK.
  • Harky A; Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.
J Card Surg ; 36(1): 178-187, 2021 Jan.
Article em En | MEDLINE | ID: mdl-33085112
OBJECTIVE: To compare clinical outcomes of reimplantation versus remodeling in patients undergoing valve-sparing aortic root replacement (VSRR) surgery. METHOD: Electronic database search at PubMed, Scopus, Embase, Ovid, and Google scholar was performed from inception to January 2020. Primary outcomes were aortic valve (AV) reintervention and postoperative grade of aortic insufficiency (AI) while secondary outcomes were 30-day mortality, reoperation for bleeding, and operative times. RESULTS: A total of 21 articles met the inclusion criteria. A total of 1283 patients had reimplantation while 1150 had remodeling. No difference in preoperative demographics was noted except reimplantation patients were younger (48 ± 16 vs. 56 ± 15 years; p < .00001). The cardiopulmonary bypass and aortic cross-clamp times were shorter in the remodeling cohort (168 ± 38 vs. 150 ± 37 min; p = .0001 and 133 ± 31 vs. 112 ± 30 min; p = .0002, respectively). No difference in concomitant total arch surgery (14% in reimplantation vs. 15% in remodeling; p = .53). Postoperatively, there were similar stroke rates (3% in both cohorts; p = .54), rates of reoperation for bleeding (9% in reimplantation vs. 12% in remodeling; p = .88), and 30-day mortality (3% in reimplantation vs. 4% in remodeling; p = .96). No difference in early AV reintervention (1% in reimplantation vs. 2% in remodeling; p = .07), and late AV reintervention (4% in reimplantation vs. 7% in remodeling; p = .07). The AI of +2 grade was significantly lower in the reimplantation cohort (5% vs. 8%; p = .01). CONCLUSION: Our study shows comparable clinical outcomes between both techniques. The practice of each technique is largely center and surgeon dependent. Larger sample size cohorts with minimal confounding factors are required to confirm the above findings.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência da Valva Aórtica / Implante de Prótese de Valva Cardíaca Tipo de estudo: Observational_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Card Surg Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência da Valva Aórtica / Implante de Prótese de Valva Cardíaca Tipo de estudo: Observational_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Card Surg Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos