Minimally invasive versus conventional surgery of the ascending aorta and root: a systematic review and meta-analysis
| Autor: | Sean Harrison, Hunaid A. Vohra, Gianni D Angelini, Massimo Caputo, Paul Rival, Tom A Rayner, Jelena Savović, Dominic E. Mahoney |
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| Rok vydání: | 2019 |
| Předmět: |
Reoperation
Pulmonary and Respiratory Medicine Aortic arch medicine.medical_specialty medicine.medical_treatment Reviews 030204 cardiovascular system & hematology Cochrane Library 03 medical and health sciences 0302 clinical medicine medicine.artery Intensive care Ascending aorta medicine Humans Minimally Invasive Surgical Procedures Minimally invasive Aorta Cardiopulmonary Bypass business.industry General Medicine Perioperative Sternotomy Surgery Meta-analysis 030228 respiratory system Centre for Surgical Research Median sternotomy Strictly standardized mean difference Relative risk Cardiology and Cardiovascular Medicine business Aortic surgery |
| Zdroj: | Eur J Cardiothorac Surg Rayner, T A, Harrison, S, Rival, P M, Mahoney, D E, Caputo, M, Angelini, G, Savović, J & Vohra, H 2019, ' Minimally Invasive versus Conventional Surgery of the Ascending Aorta and Root : A Systematic Review and Meta-Analysis ', European Journal of Cardio-Thoracic Surgery . https://doi.org/10.1093/ejcts/ezz177 |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | Summary Limited uptake of minimally invasive surgery (MIS) of the aorta hinders assessment of its efficacy compared to median sternotomy (MS). The objective of this systematic review is to compare operative and perioperative outcomes for MIS versus MS. Online databases Medline, EMBASE, Cochrane Library and Web of Science were searched from inception until July 2018. Both randomized and observational studies of patients undergoing aortic root, ascending aorta or aortic arch surgery by MIS versus MS were eligible for inclusion. Primary outcomes were 30-day mortality, reoperation for bleeding, perioperative renal impairment and neurological events. Intraoperative and postoperative timing measures were also evaluated. Thirteen observational studies were included comparing 1101 MIS and 1405 MS patients. The overall quality of evidence was very low for all outcomes. Mortality and the incidence of stroke were similar between the 2 cohorts. Meta-analysis demonstrated increased length of cardiopulmonary bypass (CPB) time for patients undergoing MS [standardized mean difference 0.36, 95% confidence interval (CI) 0.15–0.58; P = 0.001]. Patients receiving MS spent more time in hospital (standardized mean difference 0.30, 95% CI 0.17–0.43; P |
| Databáze: | OpenAIRE |
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