The Annals of thoracic surgery
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Meta Analysis Comparative Study
Comparison of graft patency between off-pump and on-pump coronary artery bypass grafting: an updated meta-analysis.
Currently, off-pump coronary artery bypass grafting (OPCAB) and on-pump coronary artery bypass grafting (ONCAB) are 2 well-established therapeutic strategies for patients with coronary artery disease, and debate regarding which strategy provides superior graft patency is ongoing. The current study is a meta-analysis of randomized controlled trials that compared the graft patency between OPCAB and ONCAB. ⋯ Meta-analysis of currently available randomized controlled trials on graft patency shows that ONCAB reduces the incidence of SVG graft occlusion significantly but does not affect LIMA and radial artery graft patency compared with OPCAB.
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Meta Analysis Comparative Study
Similar survival after mitral valve replacement or repair for ischemic mitral regurgitation: a meta-analysis.
Ischemic mitral regurgitation (IMR) occurs in 20% of patients after myocardial infarction. There is no agreement as to the best surgical option. With no prospective randomized controlled trials available, our objective was to perform a meta-analysis comparing replacement and repair. ⋯ Mitral valve repair is associated with lower operative mortality but higher recurrence of regurgitation in patients with ischemic mitral regurgitation. No differences were found regarding survival, NYHA class, and functional indicators.
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Venoarterial extracorporeal membrane oxygenation (ECMO) has been used successfully for treatment of cardiogenic shock or cardiac arrest. The exact complication rate is not well understood, in part because of small study sizes. In the absence of large clinical trials, performance of pooled analysis represents the best method for ascertaining complication rates for ECMO. ⋯ Although ECMO can improve survival of patients with advanced heart disease, there is significant associated morbidity with performance of this intervention. These findings should be incorporated in the risk-benefit analysis when initiation of ECMO for cardiogenic shock is being considered.
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Review Meta Analysis Comparative Study
Meta-analysis of staged versus combined carotid endarterectomy and coronary artery bypass grafting.
The multiple options in the management of patients with concomitant carotid and coronary artery disease (CAD) make it difficult to find a clear consensus regarding the ideal surgical strategy. We performed a meta-analysis of studies comparing early outcomes of synchronous and staged approach of carotid endarterectomy and coronary artery bypass grafting. ⋯ Our meta-analysis of observational studies suggests comparable outcomes in combined and staged approach for synchronous carotid and coronary artery disease. Hence, the 2 strategies can be used interchangeable in the clinical practice, with each having specific applications linked to specific clinical conditions. A randomized trial is warranted to answer this question definitively.
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In this article, we assessed the pooled sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in studies during the last 10 years that have solely used EBUS-TBNA as a minimally invasive technique, with or without computed tomography or positron-emission tomography screening. The meta-analysis included 1,066 patients from 9 studies who underwent EBUS-TBNA. ⋯ It has excellent sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. EBUS-TBNA is well tolerated and does not lead to complications in patients.