期刊
PERFUSION-UK
卷 -, 期 -, 页码 -出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/02676591231174579
关键词
Minimally invasive mitral valve surgery; conventional sternotomy; Mitral valve; propensity score matching; meta-analysis
This study compared the outcomes between minimally invasive mitral valve surgery (MIMVS) and conventional sternotomy (CS) through a review and meta-analysis. The results showed that MIMVS was associated with lower risks of renal failure, new onset atrial fibrillation, mortality, and prolonged intubation compared to CS. Additionally, MIMVS had shorter ICU stay and time to discharge.
Objectives Early meta-analyses comparing minimally invasive mitral valve surgery (MIMVS) with conventional sternotomy (CS) have determined the safety of MIMVS. We performed this review and meta-analysis based on studies from 2014 onwards to examine the differences in outcomes between MIMVS and CS. Specifically, some outcomes of interest included renal failure, new onset atrial fibrillation, mortality, stroke, reoperation for bleeding, blood transfusion and pulmonary infection. Methods A systematic search was performed in six databases for studies comparing MIMVS with CS. Although the initial search identified 821 papers in total, nine studies were suitable for the final analysis. All studies included compared CS with MIMVS. The Mantel - Haenszel statistical method was chosen due the use of inverse variance and random effects. A meta-analysis was performed on the data. Results MIMVS had significantly lower odds of renal failure (OR: 0.52; 95% CI 0.37 to 0.73, p < 0.001), new onset atrial fibrillation (OR: 0.78; 95% CI 0.67 to 0.90, p < 0.001), reduced prolonged intubation (OR: 0.50; 95% CI 0.29 to 0.87, p = 0.01) and reduced mortality (OR: 0.58; 95% CI 0.38 to 0.87, p < 0.01). MIMVS had shorter ICU stay (WMD: -0.42; 95% CI -0.59 to -0.24, p < 0.001) and shorter time to discharge (WMD: -2.79; 95% CI -3.86 to -1.71, p < 0.001). Conclusion In the modern era, MIMVS for degenerative disease is associated with improved short-term outcomes when compared to the CS.
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