Effect of native aortic valve sparing aortic root reconstruction surgery on short- and long-term prognosis in Marfan syndrome patients:a meta-analysis / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>This meta-analysis was performed to analyze the effect of preserving the native aortic valve on short- and long-term prognosis post aortic root reconstruction surgery for patients with Marfan syndrome.</p><p><b>METHODS</b>Database including Pubmed,Embase, Cochrane library, CNKI, Wanfang,VIP and CBM were searched to collect studies comparing clinical results of valve sparing surgery with composite valve graft surgery for patients with Marfan syndrome. Study quality was assessed by Newcastle-Ottawa Scale and publication bias was assessed by visual inspection of the funnel plot together with Egger test. Clinical outcomes data was extracted from the manuscripts and analyzed with Revman 5.0 supplied by Cochrane collaboration.</p><p><b>RESULTS</b>Seven clinical trials with 690 patients were included. Meta- analysis demonstrated that valve sparing surgery was associated with a lower incidence of re-exploration (RR = 0.51, 95%CI0.29- 0.90, P < 0.05), thromboembolism (RR = 0.17, 95%CI0.05-0.57, P < 0.01), endocarditis (RR = 0.31, 95%CI0.11-0.94, P < 0.05) and significantly lower long-term death rate (RR = 0.37, 95%CI0.18-0.74, P < 0.01). Reoperation rate was similar between the two groups (RR = 1.07, 95%CI0.35-3.27, P > 0.05).</p><p><b>CONCLUSION</b>Valve sparing aortic root reconstruction surgery is a superior procedure to composite valve graft surgery in term of improving the short- and long-term prognosis for patients with Marfan syndrome.</p>