초록접수 현황
| 20F-020 | 구연 발표 |
Direct Comparison of Rapid Deployment Versus Sutureless Aortic Valve Replacement: a Meta-Analysis
Suk Ho Sohn, Yoonjin Kang, Ji Seong Kim, Jae Woong Choi, Myoung-jin Jang, Ho Young Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Purpose : This meta-analysis was conducted to compare the early and follow-up outcomes of aortic valve replacement (AVR) using rapid deployment valve (RD group) versus sutureless valve (SU group).
Methods : A literature search of 5 online databases was conducted. Primary outcomes were aortic cross-clamp (ACC) and cardiopulmonary bypass (CPB) times, mean transvalvular pressure gradient after AVR (AVMPG), incidence of paravalvular leak (PVL) and need for permanent pacemaker implantation (PPI). Secondary outcomes included early mortality and other postoperative complications, such as atrial fibrillation, bleeding reoperation and stroke.
Results : Eight articles (RD group = 842 patients, SU group = 1,386 patients) were included. Pooled analyses showed that ACC and CPB times were significantly longer in RD group than in SU group, with weighted mean differences (MDs) of 8.74 (P<.001) and 9.94 (P<.001) minutes, respectively. Pooled analysis demonstrated a lower AVMPG in RD group than in SU group (MD of 2.64mmHg). Pooled risk ratios (RRs) of any PVL and grade≥2 (or moderate) PVL were not significantly different between the groups; however, the incidence of PPI was significantly lower in RD group than in SU group, with a RR of 0.69. The risks of early mortality and other postoperative complications were not significantly different between the groups.
Conclusion : AVR using RD valve was associated with significantly longer procedural times than AVR using SU valve. However, the valve hemodynamics in terms of the AVMPG was significantly better in RD group than in SU group, and better outcomes were observed in RD group regarding PPI.
Methods : A literature search of 5 online databases was conducted. Primary outcomes were aortic cross-clamp (ACC) and cardiopulmonary bypass (CPB) times, mean transvalvular pressure gradient after AVR (AVMPG), incidence of paravalvular leak (PVL) and need for permanent pacemaker implantation (PPI). Secondary outcomes included early mortality and other postoperative complications, such as atrial fibrillation, bleeding reoperation and stroke.
Results : Eight articles (RD group = 842 patients, SU group = 1,386 patients) were included. Pooled analyses showed that ACC and CPB times were significantly longer in RD group than in SU group, with weighted mean differences (MDs) of 8.74 (P<.001) and 9.94 (P<.001) minutes, respectively. Pooled analysis demonstrated a lower AVMPG in RD group than in SU group (MD of 2.64mmHg). Pooled risk ratios (RRs) of any PVL and grade≥2 (or moderate) PVL were not significantly different between the groups; however, the incidence of PPI was significantly lower in RD group than in SU group, with a RR of 0.69. The risks of early mortality and other postoperative complications were not significantly different between the groups.
Conclusion : AVR using RD valve was associated with significantly longer procedural times than AVR using SU valve. However, the valve hemodynamics in terms of the AVMPG was significantly better in RD group than in SU group, and better outcomes were observed in RD group regarding PPI.
책임저자: Ho Young Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital
발표자: Suk Ho Sohn, E-mail : xsshssx@gmail.com