{"title":"孤立三尖瓣手术中心脏跳动与心脏骤停:kaplan - meier衍生meta分析。","authors":"Massimo Baudo, Serge Sicouri, Yoshiyuki Yamashita, Dimitrios Magouliotis, Francesco Cabrucci, Basel Ramlawi","doi":"10.1177/15569845251375959","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study was to analyze the clinical and surgical outcomes of patients undergoing isolated tricuspid valve surgery (ITVS) from the available literature. It currently remains uncertain whether arrested heart (AH) surgery has superior postoperative outcomes over beating heart (BH) for ITVS.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted by searching PubMed, ScienceDirect, Scopus, DOAJ, SciELO, and Cochrane databases from 2000 until November 2024. The protocol was registered with the International Prospective Register of Systematic Reviews under the PROSPERO registration number CRD42024622618.</p><p><strong>Results: </strong>A total of 22 studies met the inclusion criteria. These studies were published between 2012 and 2023 and included a combined total of 1,627 patients, with 1,053 in the BH group and 574 in the AH group. The present analysis showed that patients undergoing BH surgery were generally more comorbid and more frequently underwent minimally invasive procedures as compared with patients undergoing AH surgery. The BH and AH groups reported no significant differences in postoperative outcomes. At follow-up, BH was associated with higher recurrent >2+ tricuspid regurgitation rates (<i>P</i> = 0.048), but this did not affect late survival (hazard ratio [HR] = 0.90, 95% confidence interval [CI]: 0.68 to 1.19, <i>P</i> = 0.457) or reintervention for TV (HR = 1.18, 95% CI: 0.61 to 2.29, <i>P</i> = 0.622) rates.</p><p><strong>Conclusions: </strong>A consensus between BH and AH for ITVS is still lacking. However, BH ITVS procedures appear to be the preferred surgeon choice for higher-risk patients. At follow-up, the BH group showed higher rates of recurrent tricuspid regurgitation >2+, without affecting late survival or rates of TV reintervention.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251375959"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Beating Heart Versus Arrested Heart for Isolated Tricuspid Valve Surgery: A Kaplan-Meier-Derived Meta-Analysis.\",\"authors\":\"Massimo Baudo, Serge Sicouri, Yoshiyuki Yamashita, Dimitrios Magouliotis, Francesco Cabrucci, Basel Ramlawi\",\"doi\":\"10.1177/15569845251375959\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The aim of the current study was to analyze the clinical and surgical outcomes of patients undergoing isolated tricuspid valve surgery (ITVS) from the available literature. It currently remains uncertain whether arrested heart (AH) surgery has superior postoperative outcomes over beating heart (BH) for ITVS.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted by searching PubMed, ScienceDirect, Scopus, DOAJ, SciELO, and Cochrane databases from 2000 until November 2024. The protocol was registered with the International Prospective Register of Systematic Reviews under the PROSPERO registration number CRD42024622618.</p><p><strong>Results: </strong>A total of 22 studies met the inclusion criteria. These studies were published between 2012 and 2023 and included a combined total of 1,627 patients, with 1,053 in the BH group and 574 in the AH group. The present analysis showed that patients undergoing BH surgery were generally more comorbid and more frequently underwent minimally invasive procedures as compared with patients undergoing AH surgery. The BH and AH groups reported no significant differences in postoperative outcomes. At follow-up, BH was associated with higher recurrent >2+ tricuspid regurgitation rates (<i>P</i> = 0.048), but this did not affect late survival (hazard ratio [HR] = 0.90, 95% confidence interval [CI]: 0.68 to 1.19, <i>P</i> = 0.457) or reintervention for TV (HR = 1.18, 95% CI: 0.61 to 2.29, <i>P</i> = 0.622) rates.</p><p><strong>Conclusions: </strong>A consensus between BH and AH for ITVS is still lacking. However, BH ITVS procedures appear to be the preferred surgeon choice for higher-risk patients. At follow-up, the BH group showed higher rates of recurrent tricuspid regurgitation >2+, without affecting late survival or rates of TV reintervention.</p>\",\"PeriodicalId\":13574,\"journal\":{\"name\":\"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery\",\"volume\":\" \",\"pages\":\"15569845251375959\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/15569845251375959\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/15569845251375959","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Beating Heart Versus Arrested Heart for Isolated Tricuspid Valve Surgery: A Kaplan-Meier-Derived Meta-Analysis.
Objective: The aim of the current study was to analyze the clinical and surgical outcomes of patients undergoing isolated tricuspid valve surgery (ITVS) from the available literature. It currently remains uncertain whether arrested heart (AH) surgery has superior postoperative outcomes over beating heart (BH) for ITVS.
Methods: A systematic review and meta-analysis were conducted by searching PubMed, ScienceDirect, Scopus, DOAJ, SciELO, and Cochrane databases from 2000 until November 2024. The protocol was registered with the International Prospective Register of Systematic Reviews under the PROSPERO registration number CRD42024622618.
Results: A total of 22 studies met the inclusion criteria. These studies were published between 2012 and 2023 and included a combined total of 1,627 patients, with 1,053 in the BH group and 574 in the AH group. The present analysis showed that patients undergoing BH surgery were generally more comorbid and more frequently underwent minimally invasive procedures as compared with patients undergoing AH surgery. The BH and AH groups reported no significant differences in postoperative outcomes. At follow-up, BH was associated with higher recurrent >2+ tricuspid regurgitation rates (P = 0.048), but this did not affect late survival (hazard ratio [HR] = 0.90, 95% confidence interval [CI]: 0.68 to 1.19, P = 0.457) or reintervention for TV (HR = 1.18, 95% CI: 0.61 to 2.29, P = 0.622) rates.
Conclusions: A consensus between BH and AH for ITVS is still lacking. However, BH ITVS procedures appear to be the preferred surgeon choice for higher-risk patients. At follow-up, the BH group showed higher rates of recurrent tricuspid regurgitation >2+, without affecting late survival or rates of TV reintervention.
期刊介绍:
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery