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Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair

Aortic valve repair is still emerging, and its role in the treatment of bicuspid aortic valve disease (BAVD) is not yet fully understood. Our objective is to synthesise available evidence on outcomes after surgical aortic valve repair in patients with BAVD. We conducted a systematic review of clinic...

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Autores principales: Salcher, Maximilian, Naci, Huseyin, Pender, Sarah, Kuehne, Titus, Kelm, Marcus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174788/
https://www.ncbi.nlm.nih.gov/pubmed/28008357
http://dx.doi.org/10.1136/openhrt-2016-000502
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author Salcher, Maximilian
Naci, Huseyin
Pender, Sarah
Kuehne, Titus
Kelm, Marcus
author_facet Salcher, Maximilian
Naci, Huseyin
Pender, Sarah
Kuehne, Titus
Kelm, Marcus
author_sort Salcher, Maximilian
collection PubMed
description Aortic valve repair is still emerging, and its role in the treatment of bicuspid aortic valve disease (BAVD) is not yet fully understood. Our objective is to synthesise available evidence on outcomes after surgical aortic valve repair in patients with BAVD. We conducted a systematic review of clinical studies using prespecified methods for searching, identifying and selecting eligible studies in 4 databases, and synthesising results (PROSPERO 2014:CRD42014014415). 2 researchers independently reviewed full-text articles and extracted data. The results of included studies were quantitatively synthesised in frequentist meta-analyses. We included 11 aortic valve repair studies or study arms with a total of 2010 participants. Pooled estimates for the proportion of patients surviving at 30 days, 1 year, 5 years and 10 years were 0.995 (95% CI 0.991 to 0.995), 0.994 (0.989 to 0.999), 0.945 (0.898 to 0.993) and 0.912 (0.845 to 0.979), respectively. The pooled proportion of late deaths from valve-related causes was 0.008 (0.000 to 0.019) at a mean follow-up of 3.5 years. Proportion of patients with valve-related reinterventions was 0.075 (0.037 to 0.113) at a mean follow-up of 3.9 years, and the linearised reintervention rate was 1.3 (0.7 to 1.9) per 100 patient-years. Outcome reporting was insufficient to pool the results for a number of predefined outcomes. In conclusion, existing evidence on aortic valve repair in BAVD is limited to mostly small case series, case–control and small retrospective cohort studies. Despite the low quality, available evidence suggests favourable survival outcomes after aortic valve repair in selected patients with BAVD. Valve-related reinterventions at follow-up are common in all patients undergoing repair surgery.
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spelling pubmed-51747882016-12-22 Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair Salcher, Maximilian Naci, Huseyin Pender, Sarah Kuehne, Titus Kelm, Marcus Open Heart Review Aortic valve repair is still emerging, and its role in the treatment of bicuspid aortic valve disease (BAVD) is not yet fully understood. Our objective is to synthesise available evidence on outcomes after surgical aortic valve repair in patients with BAVD. We conducted a systematic review of clinical studies using prespecified methods for searching, identifying and selecting eligible studies in 4 databases, and synthesising results (PROSPERO 2014:CRD42014014415). 2 researchers independently reviewed full-text articles and extracted data. The results of included studies were quantitatively synthesised in frequentist meta-analyses. We included 11 aortic valve repair studies or study arms with a total of 2010 participants. Pooled estimates for the proportion of patients surviving at 30 days, 1 year, 5 years and 10 years were 0.995 (95% CI 0.991 to 0.995), 0.994 (0.989 to 0.999), 0.945 (0.898 to 0.993) and 0.912 (0.845 to 0.979), respectively. The pooled proportion of late deaths from valve-related causes was 0.008 (0.000 to 0.019) at a mean follow-up of 3.5 years. Proportion of patients with valve-related reinterventions was 0.075 (0.037 to 0.113) at a mean follow-up of 3.9 years, and the linearised reintervention rate was 1.3 (0.7 to 1.9) per 100 patient-years. Outcome reporting was insufficient to pool the results for a number of predefined outcomes. In conclusion, existing evidence on aortic valve repair in BAVD is limited to mostly small case series, case–control and small retrospective cohort studies. Despite the low quality, available evidence suggests favourable survival outcomes after aortic valve repair in selected patients with BAVD. Valve-related reinterventions at follow-up are common in all patients undergoing repair surgery. BMJ Publishing Group 2016-12-16 /pmc/articles/PMC5174788/ /pubmed/28008357 http://dx.doi.org/10.1136/openhrt-2016-000502 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Review
Salcher, Maximilian
Naci, Huseyin
Pender, Sarah
Kuehne, Titus
Kelm, Marcus
Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair
title Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair
title_full Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair
title_fullStr Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair
title_full_unstemmed Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair
title_short Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair
title_sort bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174788/
https://www.ncbi.nlm.nih.gov/pubmed/28008357
http://dx.doi.org/10.1136/openhrt-2016-000502
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