Comparison of Various Surgical Approaches for Moderate-to-Severe Ischemic Mitral Regurgitation: A Systematic Review and Network Meta-Analysis.

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reviews in cardiovascular medicine Pub Date : 2024-11-25 eCollection Date: 2024-11-01 DOI:10.31083/j.rcm2511425
Zhili Wei, Shuai Dong, Xuhua Li, Yang Chen, Shidong Liu, Bing Song
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引用次数: 0

Abstract

Background: This study aims to systematically review the efficacy of various surgical approaches in the treatment of ischemic mitral regurgitation (IMR).

Methods: A comprehensive literature search was conducted using computerized databases, including PubMed, Cochrane Library, Embase, and Web of Science, up to February 2024. In our network meta-analysis, we utilized the Cochrane Handbook tool for quality evaluation, while a consistency model and the odds ratio (OR) were used to compile and analyze the data from the studies included, employing Stata 17.0 software for this purpose.

Results: The systematic review included a total of 20 randomized controlled trials (RCTs), which collectively involved 3111 patients and evaluated six different surgical techniques. The network meta-analysis demonstrated that mitral valve repair (MVr) exhibited a significant reduction in 30-day all-cause mortality rates when compared to coronary artery bypass grafting (CABG), mitral valve replacement (MVR), CABG combined with MVR, and transcatheter mitral valve edge-to-edge repair (TEER) using MitraClip. Furthermore, probability ranking analysis suggested that MVr may be the most effective approach in reducing 30-day all-cause mortality, while CABG combined with MVr had significantly fewer renal complications compared to CABG combined with MVR. Probability rankings also indicated that CABG+MVr may be the most effective technique in minimizing renal complications. However, there were no statistically significant differences observed in other outcome measures among the different surgical techniques.

Conclusions: Current limited evidence indicates that CABG combined with MVr may be the best surgical approach for patients with IMR. However, these conclusions are tentative and require further confirmation from more additional high-quality studies.

Inplasy registration number: INPLASY202420049. This study can be accessed at the following detailed address: https://inplasy.com/inplasy-2024-2-0049/, last accessed on February 11, 2024.

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来源期刊
Reviews in cardiovascular medicine
Reviews in cardiovascular medicine 医学-心血管系统
CiteScore
2.70
自引率
3.70%
发文量
377
审稿时长
1 months
期刊介绍: RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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