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Long-Term Outcomes of Sternal-Sparing Versus Sternotomy Approaches for Mitral Valve Repair: Meta-Analysis of Reconstructed Time-to-Event Data
- Source :
- Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 18:167-174
- Publication Year :
- 2023
- Publisher :
- SAGE Publications, 2023.
-
Abstract
- Objective: Since there are concerns about the durability of mitral valve repair (MVRp) with minimally invasive techniques in patients with mitral regurgitation (MR), we aimed to evaluate the long-term outcomes of these sternal-sparing approaches when compared with conventional approaches with sternotomy in patients undergoing MVRp. Methods: We performed a systematic review according to a preestablished protocol and performed a pooled analysis of Kaplan–Meier–derived reconstructed time-to-event data from studies with longer follow-up comparing sternal-sparing versus sternotomy approaches for MVRp. Our outcomes of interest were survival, freedom from recurrent MR, and freedom from reoperation. Results: Eleven studies met our eligibility criteria comprising 7,596 patients with follow-up (sternal sparing, n = 4,246; sternotomy, n = 3,350). Patients who underwent sternal-sparing MVRp had a significantly lower risk of mortality over time compared with patients who underwent MVRp with sternotomy (hazard ratio [HR] = 0.29, 95% confidence interval [CI]: 0.23 to 0.36, P < 0.001) in the overall analysis. However, we found no statistically significant difference between the groups in the sensitivity analysis with adjusted populations (HR = 0.85, 95% CI: 0.63 to 1.15, P = 0.301). Regarding the outcomes freedom from recurrent MR and freedom from reoperation, we found no statistically significant differences between the groups in the follow-up in both overall and sensitivity analyses. Conclusions: In comparison with MVRp with sternotomy approaches, sternal-sparing MVRp was not associated with worse outcomes in terms of survival, recurrent MR, and reoperations over time.
Details
- ISSN :
- 15590879 and 15569845
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
- Accession number :
- edsair.doi...........6a86c3deacfe1430b2b701e0cd5ac720
- Full Text :
- https://doi.org/10.1177/15569845231166902