Systematic review and meta-analysis of surgical outcomes comparing mechanical valve replacement and bioprosthetic valve replacement in infective endocarditis
| Autor: | Gösta B. Pettersson, Isabel Zegri-Reiriz, Manel Tauron, Neil P. Curran, Stephanie Chan, Joseph S. Coselli, Martin Misfeld, Campbell D. Flynn, Eduard Quintana, David H. Tian, Manuel J. Antunes, Carlos A. Mestres |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population 030204 cardiovascular system & hematology Prosthesis Intracardiac injection 03 medical and health sciences 0302 clinical medicine Valve replacement medicine mechanical education education.field_of_study bioprosthesis infective endocarditis business.industry Mortality rate Hazard ratio medicine.disease Confidence interval Surgery bioprosthetic 030228 respiratory system Infective endocarditis Systematic Review Cardiology and Cardiovascular Medicine business tissue valve |
| Zdroj: | Annals of Cardiothoracic Surgery r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 2225-319X |
| Popis: | Background: Infective endocarditis (IE) is an infection involving either native or prosthetic heart valves, the endocardial surface of the heart or any implanted intracardiac devices. IE is a rare condition affecting 3-15 patients per 100,000 population. In-hospital mortality rates in patients with IE remain high at around 20% despite treatment advances. There is no consensus recommendation favoring either bioprosthetic valve or mechanical valve implantation in the setting of IE; patient age, co-morbidities and preferences should be considered selecting the replacement prosthesis. Methods: A systematic review and meta-analysis of studies reporting the outcomes of patients undergoing bioprosthetic or mechanical valve replacement for infective endocarditis with data extracted for overall survival, valve reinfection rates and valve reoperation. Results: Eleven relevant studies were identified, with 2,336 patients receiving a mechanical valve replacement and 2,057 patients receiving a bioprosthetic valve replacement. There was no significant difference for overall survival between patients treated with mechanical valves and those treated with bioprosthetic valves [hazard ratio (HR) 0.94, 95% confidence interval (CI): 0.73-1.21, P=0.62]. There was no significant difference in reoperation rates between patients treated with a bioprosthetic valve and those treated with a mechanical valve (HR 0.82, 95% CI: 0.34-1.98, P=0.66) and there was no significant difference in the rate of valve reinfection rates (HR 0.95, 95% CI: 0.48-1.89, P=0.89). Conclusions: The presence of infective endocarditis alone should not influence the decision of which type of valve prosthesis that should be implanted. This decision should be based on patient age, co-morbidities and preferences. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|