A Meta-Analysis on Prophylactic Donor Heart Tricuspid Annuloplasty in Orthotopic Heart Transplantation: High Hopes from a Small Intervention
| Autor: | Andrei Tarus, Mihail Enache, Alexandru Burlacu, Alberto Emanuel Bacusca, Grigore Tinica |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Leadership and Management medicine.medical_treatment tricuspid annuloplasty lcsh:Medicine Health Informatics Review Regurgitation (circulation) 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Tricuspid annuloplasty Health Information Management medicine 030212 general & internal medicine heart transplant tricuspid regurgitation Heart transplantation business.industry Health Policy Incidence (epidemiology) lcsh:R Tricuspid insufficiency medicine.disease Surgery meta-analysis Donor heart prophylactic Meta-analysis Cohort business |
| Zdroj: | Healthcare Healthcare, Vol 9, Iss 306, p 306 (2021) |
| ISSN: | 2227-9032 |
| DOI: | 10.3390/healthcare9030306 |
| Popis: | (1) Background: Tricuspid regurgitation (TR) is the most frequent valvulopathy in heart transplant recipients (HTX). We aimed to assess the influence of prophylactic donor heart tricuspid annuloplasty (TA) in orthotopic HTX (HTX-A), comparing the outcomes with those of HTX patients. (2) Methods: Electronic databases of PubMed, EMBASE, and SCOPUS were searched. The endpoints were as follows: the overall rate of postprocedural TR (immediate, one week, six months, and one year after the procedure), postoperative complications (permanent pacemaker implantation rate, bleeding), redo surgery for TR, and mortality. (3) Results: This meta-analysis included seven studies. Immediate postprocedural, one-week, six-month and one-year tricuspid insufficiency rates were significantly lower in the HTX-A group. There was no difference in permanent pacemaker implantation rate between the groups. The incidence of postoperative bleeding was similar in both arms. The rate of redo surgery for severe TR was reported only by two authors. In both publications, the total number of events was higher in the HTX cohort, meanwhile pooled effect analysis showed no difference among the intervention and control groups. Mortality at one year was similar in both arms. (4) Conclusion: Our study showed that donor heart TA reduces TR incidence in the first year after orthotopic heart transplantation without increasing the surgical complexity. This is a potentially important issue, given the demand for heart transplants and the need to optimize outcomes when this resource is scarce. |
| Databáze: | OpenAIRE |
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