https://scholars.lib.ntu.edu.tw/handle/123456789/433950
標題: | Outcome of surgical intervention for aortic root abscess: A meta-analysis | 作者: | Chen G.-J. Lo W.-C. Tseng H.-W. SUNG-CHING PAN YIH-SHARNG CHEN SHAN-CHWEN CHANG |
公開日期: | 2018 | 出版社: | European Association for Cardio-Thoracic Surgery | 卷: | 53 | 期: | 4 | 起(迄)頁: | 807-814 | 來源出版物: | European Journal of Cardio-thoracic Surgery | 摘要: | OBJECTIVES: Aortic root abscess (ARA) is a catastrophic complication of aortic root endocarditis, involving both native and prosthetic valves, which often warrants surgical intervention. Currently, aortic valve replacement (AVR) and aortic root replacement (ARR) are the most widely employed techniques. However, evidence that directly compares these methods is scarce. In this meta-analysis, we aimed to describe the surgical outcome of ARA when using different surgical methods. METHODS: In this meta-analysis, we performed literature searches in the EMBASE and PubMed databases and reviewed articles describing postoperative results of ARA that were published before 30 June 2016. After extracting the published data, we used a random-effects model to perform meta-analysis and compare the postoperative outcomes of ARA after management with AVR or ARR. RESULTS: Seven published studies were included in this meta-analysis, which includes 781 episodes of infective endocarditis complicated with ARA. There was no significant difference in the 30-day postoperative mortality rate among patients receiving ARR [23.8%, 95% confidence interval (CI) 17.8-30.6] compared with AVR (19.1%, 95% CI 13.3-26.1%), with a relative risk ratio of 1.30 (95% CI 0.84-2.00). However, patients receiving ARR were associated with statistically significant lower rates of reoperation within 1 year (relative risk 0.50, 95% CI 0.26-0.94). CONCLUSIONS: In our meta-analysis, ARR was associated with a 50% risk reduction of reoperation within 1 year among patients with ARA. There was no significant difference in the 30-day postoperative mortality rate between patients receiving ARR and patients receiving AVR; comparison of the long-term outcomes after these 2 procedures warrants further investigation. ? The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044844496&doi=10.1093%2fejcts%2fezx421&partnerID=40&md5=fe6e8bda2d7962ec545d29c918c02ff0 https://scholars.lib.ntu.edu.tw/handle/123456789/433950 |
ISSN: | 1010-7940 | DOI: | 10.1093/ejcts/ezx421 | SDG/關鍵字: | abscess; adult; aortic root abscess; aortic surgery; Article; bacterial endocarditis; cause of death; female; human; major clinical study; male; meta analysis; mortality rate; nonhuman; postoperative period; priority journal; reoperation; risk reduction; Staphylococcus aureus; Streptococcus; surgical mortality; surgical risk; abscess; aortic disease; aortic valve; endocarditis; heart valve replacement; mortality; risk factor; treatment outcome; Abscess; Aortic Diseases; Aortic Valve; Endocarditis; Heart Valve Prosthesis Implantation; Humans; Risk Factors; Treatment Outcome |
顯示於: | 醫學系 |
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