{"title":"三尖瓣反流患者三尖瓣修复术中的硬环与软带：系统回顾和荟萃分析","authors":"Shadi Alaa Abdelaal , Mahmoud Tarek Hefnawy , Enas Ewais , Naydeen Mostafa , Ahmed Mohamed Abozaid , Adel Mouffokes , Amnir Moustapha , Mohamed Mohamed , Hazem S. Ghaith , Alaa Ramadan , Nathan Ezie Kengo , Ahmed Negida","doi":"10.1016/j.ijcrp.2024.200296","DOIUrl":null,"url":null,"abstract":"<div><h3>Background & objectives</h3><p>Rigid ring and Flexible band are techniques used to repair tricuspid valve regurgitation. The comparison between both techniques' effectiveness is controversial in the literature. We conducted this systematic review and meta-analysis to compare the safety and efficacy of rigid ring versus flexible band for tricuspid valve repair in patients with tricuspid valve regurgitation.</p></div><div><h3>Methods</h3><p>We conducted a PRISMA-compliant systematic review and meta-analysis. A systematic search was performed in major databases, including PubMed, Scopus, Web of Science, and Cochrane CENTRAL to identify relevant published studies. Data were extracted and analyzed using Stata (version 17 for Mac) and Revman (version 5.4 for Windows).</p></div><div><h3>Results</h3><p>Twelve studies were included in this meta-analysis. Total number of patients was 4259. The rigid ring wasn't superior to the flexible band in terms of postoperative tricuspid regurgitation RR 0.74, 95 % CI (0.43–1.27) (P = 0.29). However, the results were not homogeneous. After employing sensitivity analysis, the significance of the pooled effect estimate didn't change, showing no significant difference between the two annuloplasty RR 0.72, 95%CI (0.45–1.15). On the other hand, the rigid ring was associated with a higher bypass time than the flexible band (RR 4.85, P = 0.00). There were no differences between the two groups in terms of hospital stay, ICU stays, prolonged ventilation, mechanical ventilation time, annuloplasty size, stroke, concomitant mitral valve surgery, concomitant aortic valve surgery, atrial fibrillation, pacemaker implantation, low cardiac output, in-hospital death, or late death (all P > 0.05).</p></div><div><h3>Conclusion</h3><p>Our study findings suggested no difference between rigid ring compared to flexible band regarding the rates of postoperative tricuspid regurgitation; however, rigid ring may encompass a higher bypass time. Therefore, further research is required to ensure our findings.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200296"},"PeriodicalIF":1.9000,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000618/pdfft?md5=9aed2c1aa6c12e009ce3cb659e4ba50d&pid=1-s2.0-S2772487524000618-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Rigid ring vs. flexible band for tricuspid valve repair in patients with tricuspid valve regurgitation: A systematic review and meta-analysis\",\"authors\":\"Shadi Alaa Abdelaal , Mahmoud Tarek Hefnawy , Enas Ewais , Naydeen Mostafa , Ahmed Mohamed Abozaid , Adel Mouffokes , Amnir Moustapha , Mohamed Mohamed , Hazem S. Ghaith , Alaa Ramadan , Nathan Ezie Kengo , Ahmed Negida\",\"doi\":\"10.1016/j.ijcrp.2024.200296\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background & objectives</h3><p>Rigid ring and Flexible band are techniques used to repair tricuspid valve regurgitation. The comparison between both techniques' effectiveness is controversial in the literature. We conducted this systematic review and meta-analysis to compare the safety and efficacy of rigid ring versus flexible band for tricuspid valve repair in patients with tricuspid valve regurgitation.</p></div><div><h3>Methods</h3><p>We conducted a PRISMA-compliant systematic review and meta-analysis. A systematic search was performed in major databases, including PubMed, Scopus, Web of Science, and Cochrane CENTRAL to identify relevant published studies. Data were extracted and analyzed using Stata (version 17 for Mac) and Revman (version 5.4 for Windows).</p></div><div><h3>Results</h3><p>Twelve studies were included in this meta-analysis. Total number of patients was 4259. The rigid ring wasn't superior to the flexible band in terms of postoperative tricuspid regurgitation RR 0.74, 95 % CI (0.43–1.27) (P = 0.29). However, the results were not homogeneous. After employing sensitivity analysis, the significance of the pooled effect estimate didn't change, showing no significant difference between the two annuloplasty RR 0.72, 95%CI (0.45–1.15). On the other hand, the rigid ring was associated with a higher bypass time than the flexible band (RR 4.85, P = 0.00). There were no differences between the two groups in terms of hospital stay, ICU stays, prolonged ventilation, mechanical ventilation time, annuloplasty size, stroke, concomitant mitral valve surgery, concomitant aortic valve surgery, atrial fibrillation, pacemaker implantation, low cardiac output, in-hospital death, or late death (all P > 0.05).</p></div><div><h3>Conclusion</h3><p>Our study findings suggested no difference between rigid ring compared to flexible band regarding the rates of postoperative tricuspid regurgitation; however, rigid ring may encompass a higher bypass time. 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引用次数: 0
摘要
背景& 目的刚环和柔性带是用于修复三尖瓣反流的技术。这两种技术的有效性比较在文献中存在争议。我们进行了这项系统性回顾和荟萃分析，以比较刚性环和柔性带对三尖瓣反流患者进行三尖瓣修复的安全性和有效性。我们在主要数据库（包括 PubMed、Scopus、Web of Science 和 Cochrane CENTRAL）中进行了系统检索，以确定已发表的相关研究。使用Stata（Mac版17）和Revman（Windows版5.4）对数据进行提取和分析。患者总数为 4259 人。就术后三尖瓣反流而言，刚性环并不比柔性带更优，RR 0.74，95 % CI (0.43-1.27) (P = 0.29)。然而，结果并不一致。采用敏感性分析后，汇总效应估计值的显著性没有改变，显示两种瓣环成形术 RR 0.72，95%CI（0.45-1.15）之间没有显著差异。另一方面，刚性环比柔性带的分流时间更长（RR 4.85，P = 0.00）。两组患者在住院时间、重症监护室停留时间、延长通气时间、机械通气时间、瓣环成形术大小、卒中、并发二尖瓣手术、并发主动脉瓣手术、心房颤动、起搏器植入、低心排量、院内死亡或晚期死亡方面没有差异（均为 P > 0.05）。结论我们的研究结果表明，在术后三尖瓣反流率方面，硬环与软带相比没有差异；但是，硬环可能需要更长的分流时间。因此，需要进一步研究以确保我们的研究结果。
Rigid ring vs. flexible band for tricuspid valve repair in patients with tricuspid valve regurgitation: A systematic review and meta-analysis
Background & objectives
Rigid ring and Flexible band are techniques used to repair tricuspid valve regurgitation. The comparison between both techniques' effectiveness is controversial in the literature. We conducted this systematic review and meta-analysis to compare the safety and efficacy of rigid ring versus flexible band for tricuspid valve repair in patients with tricuspid valve regurgitation.
Methods
We conducted a PRISMA-compliant systematic review and meta-analysis. A systematic search was performed in major databases, including PubMed, Scopus, Web of Science, and Cochrane CENTRAL to identify relevant published studies. Data were extracted and analyzed using Stata (version 17 for Mac) and Revman (version 5.4 for Windows).
Results
Twelve studies were included in this meta-analysis. Total number of patients was 4259. The rigid ring wasn't superior to the flexible band in terms of postoperative tricuspid regurgitation RR 0.74, 95 % CI (0.43–1.27) (P = 0.29). However, the results were not homogeneous. After employing sensitivity analysis, the significance of the pooled effect estimate didn't change, showing no significant difference between the two annuloplasty RR 0.72, 95%CI (0.45–1.15). On the other hand, the rigid ring was associated with a higher bypass time than the flexible band (RR 4.85, P = 0.00). There were no differences between the two groups in terms of hospital stay, ICU stays, prolonged ventilation, mechanical ventilation time, annuloplasty size, stroke, concomitant mitral valve surgery, concomitant aortic valve surgery, atrial fibrillation, pacemaker implantation, low cardiac output, in-hospital death, or late death (all P > 0.05).
Conclusion
Our study findings suggested no difference between rigid ring compared to flexible band regarding the rates of postoperative tricuspid regurgitation; however, rigid ring may encompass a higher bypass time. Therefore, further research is required to ensure our findings.
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