Long-Term Outcomes of Sternal-Sparing Versus Sternotomy Approaches for Mitral Valve Repair: Meta-Analysis of Reconstructed Time-to-Event Data
| العنوان: | Long-Term Outcomes of Sternal-Sparing Versus Sternotomy Approaches for Mitral Valve Repair: Meta-Analysis of Reconstructed Time-to-Event Data |
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| المؤلفون: | Michel Pompeu Sá, Xander Jacquemyn, Ozgun Erten, Jef Van den Eynde, Tulio Caldonazo, Torsten Doenst, Arjang Ruhparwar, Alexander Weymann, Rodrigo Oliveira Rosa Ribeiro de Souza, Roberto Rodriguez, Basel Ramlawi, Scott Goldman |
| المصدر: | Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 18:167-174 |
| بيانات النشر: | SAGE Publications, 2023. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, Surgery, General Medicine, Cardiology and Cardiovascular Medicine |
| الوصف: | Objective: Since there are concerns about the durability of mitral valve repair (MVRp) with minimally invasive techniques in patients with mitral regurgitation (MR), we aimed to evaluate the long-term outcomes of these sternal-sparing approaches when compared with conventional approaches with sternotomy in patients undergoing MVRp. Methods: We performed a systematic review according to a preestablished protocol and performed a pooled analysis of Kaplan–Meier–derived reconstructed time-to-event data from studies with longer follow-up comparing sternal-sparing versus sternotomy approaches for MVRp. Our outcomes of interest were survival, freedom from recurrent MR, and freedom from reoperation. Results: Eleven studies met our eligibility criteria comprising 7,596 patients with follow-up (sternal sparing, n = 4,246; sternotomy, n = 3,350). Patients who underwent sternal-sparing MVRp had a significantly lower risk of mortality over time compared with patients who underwent MVRp with sternotomy (hazard ratio [HR] = 0.29, 95% confidence interval [CI]: 0.23 to 0.36, P < 0.001) in the overall analysis. However, we found no statistically significant difference between the groups in the sensitivity analysis with adjusted populations (HR = 0.85, 95% CI: 0.63 to 1.15, P = 0.301). Regarding the outcomes freedom from recurrent MR and freedom from reoperation, we found no statistically significant differences between the groups in the follow-up in both overall and sensitivity analyses. Conclusions: In comparison with MVRp with sternotomy approaches, sternal-sparing MVRp was not associated with worse outcomes in terms of survival, recurrent MR, and reoperations over time. |
| تدمد: | 1559-0879 1556-9845 |
| DOI: | 10.1177/15569845231166902 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::6a86c3deacfe1430b2b701e0cd5ac720 https://doi.org/10.1177/15569845231166902 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi...........6a86c3deacfe1430b2b701e0cd5ac720 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15590879 15569845 |
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| DOI: | 10.1177/15569845231166902 |