Guan-Jhou Chen1, Wei-Cheng Lo2, Hsien-Wei Tseng3, Sung-Ching Pan1, Yih-Sharng Chen3,4, Shan-Chwen Chang1,4. 1. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 2. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. 3. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. 4. College of Medicine, National Taiwan University, Taipei, Taiwan.
Abstract
OBJECTIVES: Aortic root abscess (ARA) is a catastrophic complication of aortic root endocarditis, involving both native and prosthetic valves, which often warrants surgical intervention. Currently, aortic valve replacement (AVR) and aortic root replacement (ARR) are the most widely employed techniques. However, evidence that directly compares these methods is scarce. In this meta-analysis, we aimed to describe the surgical outcome of ARA when using different surgical methods. METHODS: In this meta-analysis, we performed literature searches in the EMBASE and PubMed databases and reviewed articles describing postoperative results of ARA that were published before 30 June 2016. After extracting the published data, we used a random-effects model to perform meta-analysis and compare the postoperative outcomes of ARA after management with AVR or ARR. RESULTS: Seven published studies were included in this meta-analysis, which includes 781 episodes of infective endocarditis complicated with ARA. There was no significant difference in the 30-day postoperative mortality rate among patients receiving ARR [23.8%, 95% confidence interval (CI) 17.8-30.6] compared with AVR (19.1%, 95% CI 13.3-26.1%), with a relative risk ratio of 1.30 (95% CI 0.84-2.00). However, patients receiving ARR were associated with statistically significant lower rates of reoperation within 1 year (relative risk 0.50, 95% CI 0.26-0.94). CONCLUSIONS: In our meta-analysis, ARR was associated with a 50% risk reduction of reoperation within 1 year among patients with ARA. There was no significant difference in the 30-day postoperative mortality rate between patients receiving ARR and patients receiving AVR; comparison of the long-term outcomes after these 2 procedures warrants further investigation.
OBJECTIVES: Aortic root abscess (ARA) is a catastrophic complication of aortic root endocarditis, involving both native and prosthetic valves, which often warrants surgical intervention. Currently, aortic valve replacement (AVR) and aortic root replacement (ARR) are the most widely employed techniques. However, evidence that directly compares these methods is scarce. In this meta-analysis, we aimed to describe the surgical outcome of ARA when using different surgical methods. METHODS: In this meta-analysis, we performed literature searches in the EMBASE and PubMed databases and reviewed articles describing postoperative results of ARA that were published before 30 June 2016. After extracting the published data, we used a random-effects model to perform meta-analysis and compare the postoperative outcomes of ARA after management with AVR or ARR. RESULTS: Seven published studies were included in this meta-analysis, which includes 781 episodes of infective endocarditis complicated with ARA. There was no significant difference in the 30-day postoperative mortality rate among patients receiving ARR [23.8%, 95% confidence interval (CI) 17.8-30.6] compared with AVR (19.1%, 95% CI 13.3-26.1%), with a relative risk ratio of 1.30 (95% CI 0.84-2.00). However, patients receiving ARR were associated with statistically significant lower rates of reoperation within 1 year (relative risk 0.50, 95% CI 0.26-0.94). CONCLUSIONS: In our meta-analysis, ARR was associated with a 50% risk reduction of reoperation within 1 year among patients with ARA. There was no significant difference in the 30-day postoperative mortality rate between patients receiving ARR and patients receiving AVR; comparison of the long-term outcomes after these 2 procedures warrants further investigation.
Authors: Sam Straw; M Wazir Baig; Vishal Mishra; Richard Gillott; Klaus K Witte; Carin Van Doorn; Antonella Ferrara; Kalyana Javangula; Jonathan A T Sandoe Journal: Front Cardiovasc Med Date: 2022-05-31
Authors: Quincy A Hathaway; Aneri B Balar; Taylor A Mallicoat; Jeffery A Voss; Md Shahrier Amin; Dhairya A Lakhani; Cathy Kim Journal: Radiol Case Rep Date: 2022-09-07
Authors: William M Harris; Shubhra Sinha; Massimo Caputo; Gianni D Angelini; Eltayeb M Ahmed; Cha Rajakaruna; Umberto Benedetto; Hunaid A Vohra Journal: J Card Surg Date: 2022-04-05 Impact factor: 1.778
Authors: Pietro Giorgio Malvindi; Elisa Mikus; Luca Caprili; Giuseppe Santarpino; Vito Margari; Simone Calvi; Giuseppe Nasso; Renato Gregorini; Carmine Carbone; Alberto Albertini; Giuseppe Speziale; Domenico Paparella Journal: Ann Cardiothorac Surg Date: 2019-11
Authors: Bo Yang; Juan Caceres; Linda Farhat; Tan Le; Bailey Brown; Emma St Pierre; Xiaoting Wu; Karen M Kim; Himanshu J Patel; G Michael Deeb Journal: J Thorac Cardiovasc Surg Date: 2020-04-13 Impact factor: 6.439
Authors: Marcin Szczechowicz; Alexander Weymann; Sabreen Mkalaluh; Ahmed Mashhour; Konstantin Zhigalov; Jerry Easo Journal: Braz J Cardiovasc Surg Date: 2020-06-01
Authors: Alisha R Bonaroti; R Wesley Edmunds; Ryan C DeCoster; James Y Liau; Michael E Sekela; Henry C Vasconez Journal: Plast Reconstr Surg Glob Open Date: 2020-10-28