Journal of the American Heart Association
Minimally Invasive Versus Sternotomy in Redo Mitral Valve Surgery: Short- and Long-Term Outcomes with Meta-Regression and Time-to-Event Analysis
Door Santos K, Kim Kim JYB, Patel N en 7 anderen.
Inhoud in het Engels
Abstract
Background
Redo mitral valve surgery carries substantial risk, and the relative benefits of minimally invasive (MI-MVS) versus sternotomy MVS, particularly regarding long-term survival, remain uncertain.
Methods
Electronic databases were searched for studies comparing MI-MVS with sternotomy MVS in adult redo MVS. Kaplan-Meier curves were digitized to reconstruct individual patient data for time-to-event analysis, with study-level hazard ratios (HR) generated using a Cox frailty model. Perioperative outcomes were pooled using random-effects models. Subgroup analyses evaluated propensity-matched cohorts, endoscopic/video-assisted minithoracotomy, and direct-vision minithoracotomy. Meta-regression explored the impact of study-level covariates on mortality.