Outcome of mitral valve repair or replacement for non-ischemic mitral regurgitation: a systematic review and meta-analysis

被引:4
作者
Fan, Qianqian [1 ,2 ]
Li, Xiaoguang [1 ,3 ]
Cao, Guilan [1 ]
Yu, Puliang [4 ]
Zhang, Fengxiao [1 ]
机构
[1] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Cardiol, Wuhan 430022, Hubei, Peoples R China
[2] Wuhan HanKou Hosp, Dept Nephrol, Wuhan 430012, Hubei, Peoples R China
[3] Jianghan Univ, Hubei Peoples Hosp 3, Dept Cardiol, Wuhan 43003, Peoples R China
[4] Wuhan Univ Sci & Technol, Key Lab Met Equipment & Control Technol, Wuhan 430081, Hubei, Peoples R China
基金
中国国家自然科学基金;
关键词
Non-ischemic mitral regurgitation; Mitral valve repair; Mitral valve replacement; Meta-analysis; LONG-TERM OUTCOMES; SURGERY; MANAGEMENT; SURVIVAL; PROLAPSE; DISEASE; LEAFLET; RISK;
D O I
10.1186/s13019-021-01563-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Mitral regurgitation (MR) is a rather common valvular heart disease. The aim of this systematic review and meta-analysis was to compare the outcomes, and complications of mitral valve (MV) replacement with surgical MV repair of non-ischemic MR (NIMR) Methods MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until October, 2020. Studies were eligible for inclusion if they included patients with MR and reported early (30-day or in-hospital) or late all-cause mortality. For each study, data on all-cause mortality and incidence of reoperation and operative complications in both groups were used to generate odds ratios (ORs) or hazard ratios (HRs). This study is registered with PROSPERO, CRD42018089608. Results The literature search yielded 4834 studies, of which 20 studies, including a total of 21,898 patients with NIMR, were included. The pooled analysis showed that lower age, less female inclusion and incident of hypertension, significantly higher rates of diabetes and atrial fibrillation in the MV replacement group than MV repair group. No significant differences in the rates of pre-operative left ventricle ejection fraction (LVEF) and heart failure were observed between groups. The number of patients in the MV repair group was lower than in the MV replacement group. We found that there were significantly increased risks of mortality associated with replacement of MR. Moreover, the rate of re-operation and post-operative MR in the MV repair group was lower than in the MV replacement group. Conclusions In patients with NIMR, MV repair achieves higher survival and leads to fewer complications than surgical MV replacement. In light of these results, we suggest that MV repair surgery should be a priority for NIMR patients.
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页数:10
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