Mitral valve repair and replacement in infectious endocarditis: a systematic review and meta-analysis of clinical outcome.

Autor: Nuthalapati U; Ivano Frankivsk National Medical University, Ivano-Frankivsk, Ukraine., Bathinapattla MR; Ivano Frankivsk National Medical University, Ivano-Frankivsk, Ukraine., Cardoso RP; AIIMS Jodhpur, Jodhpur, India., Jesi NJ; Shaheed Syed Nazrul Islam Medical College and Hospital, Kishoregonj, Bangladesh., Singh K; Government Medical College Amritsar, Amritsar, Punjab, India., Moradi I; School of Medicine, St. Georges' University, St. George's, Grenada., Gostomczyk K; Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland., Afzal M; Fatima Jinnah Medical University, Lahore, Pakistan., Omer MB; CMH Lahore Medical College & IOD, Lahore, Pakistan., Mian ZR; CMH Lahore Medical College & IOD, Lahore, Pakistan., Patel S; Teaching University Geomedi, Tbilisi, Georgia., Sachdeva P; Punjab Institute of Medical Sciences, Jalandhar, India., Malik MN; Bahawal Victoria Hospital, Bahawalpur, Pakistan., Abbas M; CMH Lahore Medical College, Lahore, Pakistan., Singh J; Verde Valley Medical Center, Cottonwood, AZ, 86326, USA., Shafique MA; Department of Medicine, Jinnah Sindh Medical University, Rafiqi H J Shaheed Road, Karachi, 75510, Pakistan. ashirshafique109@gmail.com.
Jazyk: angličtina
Zdroj: The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology [Egypt Heart J] 2024 Oct 04; Vol. 76 (1), pp. 134. Date of Electronic Publication: 2024 Oct 04.
DOI: 10.1186/s43044-024-00564-5
Abstrakt: Background: Infective endocarditis (IE) poses significant clinical challenges, often necessitating surgical intervention for improved patient outcomes. The choice between mitral valve repair (MVP) and mitral valve replacement (MVR) is crucial in managing IE. This systematic review and meta-analysis aims to compare the effectiveness of MVP and MVR in treating IE, focusing on outcomes such as postoperative bleeding, mortality, recurrent endocarditis, and stroke.
Main Text: A comprehensive literature search was conducted following PRISMA guidelines. Studies directly comparing MVP and MVR in IE patients were included. Data extraction and quality assessment were performed, and meta-analysis was conducted using RevMan software. Thirty-two studies involving 82,123 patients were included. MVP was associated with significantly lower rates of postoperative bleeding (OR: 0.58, 95% CI: 0.40-0.84) and reduced long-term mortality (OR: 0.40, 95% CI: 0.32-0.51) compared to MVR. However, MVR showed lower rates of recurrent endocarditis. MVP was also associated with a decreased likelihood of postoperative stroke (OR: 0.52, 95% CI: 0.40-0.68).2, 4 CONCLUSIONS: MVP demonstrates advantages over MVR in reducing postoperative bleeding, long-term mortality, and stroke risk in IE patients. However, individual patient factors and surgical expertise must be considered in treatment decisions. Further research, including randomized controlled trials, is needed to validate these findings and refine treatment algorithms for IE management.
(© 2024. The Author(s).)
Databáze: MEDLINE
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