Biatrial Versus Bicaval Orthotopic Heart Transplantation: A Systematic Review and Meta-Analysis
Autor: | Olivier C. Manintveld, C. Zijderhand, Johanna J.M. Takkenberg, Alina A. Constantinescu, Jasper J. Brugts, M. Mostafa Mokhles, Kevin M Veen, Ad J.J.C. Bogers, Kadir Caliskan, Tamar Schoonen, Jos A. Bekkers |
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Přispěvatelé: | Cardiothoracic Surgery, Cardiology, Department of Business-Society Management |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty genetic structures Heart disease medicine.medical_treatment 030204 cardiovascular system & hematology Rate ratio Global Health 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Heart transplantation Heart Failure Mitral regurgitation business.industry Hazard ratio Odds ratio medicine.disease eye diseases Confidence interval Survival Rate 030228 respiratory system Meta-analysis Cardiology Heart Transplantation Surgery Cardiology and Cardiovascular Medicine business |
Zdroj: | Annals of Thoracic Surgery, 110(2), 684-691. Elsevier Inc. |
ISSN: | 0003-4975 |
Popis: | Background: Orthotopic heart transplantation (OHT) is the gold standard treatment in end-stage heart disease. Controversy remains whether bicaval OHT is superior to biatrial OHT in both early and late outcomes. This study aimed to provide an overview of the early and late outcomes in patients who underwent a bicaval or biatrial OHT. Methods: A systematic literature search was performed for articles published before December 2017. Studies comparing adult patients undergoing biatrial OHT and bicaval OHT were included. Early outcomes were pooled in odds ratios and late outcomes were pooled in rate ratios. Late survival was visualized by a pooled Kaplan-Meier curve. Results: A total of 36 publications were included in the meta-analysis, counting 3555 patients undergoing biatrial OHT and 3208 patients undergoing bicaval OHT. Early outcomes in mortality, tricuspid regurgitation, mitral regurgitation, and permanent pacemaker implantation differed significantly in favor of the bicaval OHT patients. Long-term survival was significantly better in patients undergoing bicaval vs biatrial OHT (hazard ratio, 1.32; 95% confidence interval, 1.1-1.6; P = .008). Also, late tricuspid regurgitation was less frequently seen in the bicaval OHT patients (rate ratio, 2.14; 95% CI, 1.17-3.94; P = .014). Conclusions. This systematic review with meta-analysis shows that bicaval OHT results in more favorable early and late outcomes for patients undergoing a bicaval OHT compared with a biatrial OHT. Therefore, bicaval OHT should be considered as preferable technique for OHT. |
Databáze: | OpenAIRE |
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