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Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair

Salcher, Maximilian, Naci, Huseyin, Pender, Sarah, Kuehne, Titus and Kelm, Marcus (2016) Bicuspid aortic valve disease: systematic review and meta-analysis of surgical aortic valve repair. Open Heart, 3 (2). pp. 1-9. ISSN 2053-3624

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Identification Number: 10.1136/openhrt-2016-000502

Abstract

Objective: Aortic valve repair is still emerging and its role in the treatment of bicuspid aortic valve disease (BAVD) is not yet fully understood. Our objective is to synthesise available evidence on outcomes after surgical aortic valve repair in patients with BAVD. Methods: We conducted a systematic review of clinical studies using pre-specified methods for searching, identifying, and selecting eligible studies in four databases, and synthesising results (PROSPERO 2014:CRD42014014415). Two researchers independently reviewed full-text articles and extracted data. The results of included studies were quantitatively synthesised in frequentist meta-analyses. Results: We included 11 aortic valve repair studies or study arms with a total of 2010 participants. Pooled estimates for the proportion of patients surviving at 30 days, 1 year, 5 years, and 10 years were 0.995 (95% confidence interval 0.991-0.995), 0.994 (0.989-0.999), 0.945 (0.898-0.993), and 0.912 (0.845-0.979), respectively. The pooled proportion of late deaths from valve-related causes was 0.008 (0.000-0.019) at a mean follow-up of 3.5 years. Proportion of patients with valve-related reinterventions was 0.075 (0.037-0.113) at mean follow-up of 3.9 years and the linearised reintervention rate was 1.3 (0.7-1.9) per 100 patient-years. Outcome reporting was insufficient to pool the results for a number of pre-defined outcomes. Conclusions: Existing evidence on aortic valve repair in BAVD is limited to mostly small case series, case-control and small retrospective cohort studies. Despite the low quality, available evidence suggests favourable survival outcomes after aortic valve repair in selected patients with BAVD. Valve-related reinterventions at follow-up are common in all patients undergoing repair surgery.

Item Type: Article
Official URL: http://openheart.bmj.com/
Additional Information: © 2016 BMJ Publishing Group @ CC BY
Divisions: LSE Health
Subjects: R Medicine > RD Surgery
Sets: Research centres and groups > LSE Health
Date Deposited: 01 Nov 2016 10:42
Last Modified: 20 Mar 2019 03:00
Projects: 611232
Funders: European Commission
URI: http://eprints.lse.ac.uk/id/eprint/68200

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