BACKGROUND: Orthotopic heart transplantation (OHT) is the gold standard treatment in end-stage heart disease. Controversy remains whether bicaval OHT is superior to biatrial OHT in both early and late outcomes. This study aimed to provide an overview of the early and late outcomes in patients who underwent a bicaval or biatrial OHT. METHODS: A systematic literature search was performed for articles published before December 2017. Studies comparing adult patients undergoing biatrial OHT and bicaval OHT were included. Early outcomes were pooled in odds ratios and late outcomes were pooled in rate ratios. Late survival was visualized by a pooled Kaplan-Meier curve. RESULTS: In the meta-analysis 36 publications were included, counting 3555 patients undergoing biatrial OHT and 3208 patients undergoing bicaval OHT. Early outcomes in mortality, tricuspid regurgitation, mitral regurgitation and permanent pacemaker implantation differed significantly in favor of the bicaval OHT patients. Long-term survival was significantly better in patients undergoing bicaval versus biatrial OHT [hazard ratio 1.32, 95% confidence interval (CI) (1.1 to 1.6), P=0.008]. Also, late tricuspid regurgitation was less frequently seen in the bicaval OHT patients [rate ratio 2.14, CI 95% (1.17 to 3.94), P = 0.014]. CONCLUSIONS: This systematic review with meta-analysis shows that, bicaval OHT results in more favorable early and late outcomes for patients undergoing a bicaval OHT compared with biatrial OHT. Therefore, the bicaval OHT should be considered as preferable technique for OHT.
BACKGROUND: Orthotopic heart transplantation (OHT) is the gold standard treatment in end-stage heart disease. Controversy remains whether bicaval OHT is superior to biatrial OHT in both early and late outcomes. This study aimed to provide an overview of the early and late outcomes in patients who underwent a bicaval or biatrial OHT. METHODS: A systematic literature search was performed for articles published before December 2017. Studies comparing adult patients undergoing biatrial OHT and bicaval OHT were included. Early outcomes were pooled in odds ratios and late outcomes were pooled in rate ratios. Late survival was visualized by a pooled Kaplan-Meier curve. RESULTS: In the meta-analysis 36 publications were included, counting 3555 patients undergoing biatrial OHT and 3208 patients undergoing bicaval OHT. Early outcomes in mortality, tricuspid regurgitation, mitral regurgitation and permanent pacemaker implantation differed significantly in favor of the bicaval OHT patients. Long-term survival was significantly better in patients undergoing bicaval versus biatrial OHT [hazard ratio 1.32, 95% confidence interval (CI) (1.1 to 1.6), P=0.008]. Also, late tricuspid regurgitation was less frequently seen in the bicaval OHT patients [rate ratio 2.14, CI 95% (1.17 to 3.94), P = 0.014]. CONCLUSIONS: This systematic review with meta-analysis shows that, bicaval OHT results in more favorable early and late outcomes for patients undergoing a bicaval OHT compared with biatrial OHT. Therefore, the bicaval OHT should be considered as preferable technique for OHT.
Authors: Khaled D Algarni; Amr A Arafat; Claudio Pragliola; Yahya S Alhebaishi; Latifa A AlFayez; Khaled AlOtaibi; Abeer M Bakhsh; Ahmed A Amro; Adam I Adam Journal: J Saudi Heart Assoc Date: 2020-05-20
Authors: Stefan Roest; Olivier C Manintveld; Marit A E Kolff; Ferdi Akca; Jesse F Veenis; Alina A Constantinescu; Jasper J Brugts; Ozcan Birim; Lennie M van Osch-Gevers; Tamas Szili-Torok; Kadir Caliskan Journal: ESC Heart Fail Date: 2022-02-17