The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Sep 2024
Meta AnalysisMeta-Analysis of Phase-Specific Survival After Transcatheter versus Surgical Aortic Valve Replacement from Randomized Control Trials.
Transcatheter aortic valve replacement (TAVR) is an established alternative to surgical aortic valve replacement (SAVR) for severe symptomatic aortic stenosis, although phase-specific survival and cause of death are implicated following these procedures. Herein, we conducted a phase-specific meta-analysis to compare outcomes after TAVR versus SAVR. ⋯ Our analysis demonstrated phase-specific outcomes following TAVR and SAVR.
-
J. Thorac. Cardiovasc. Surg. · Jun 2024
Meta AnalysisCoronary surgery provides better survival than drug eluting stent: a pooled meta-analysis of Kaplan-Meier-derived individual patient data.
We explored the current evidence on coronary disease treatment comparing the survival of 2 therapeutic strategies: coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stent (DES). ⋯ The present meta-analysis suggests that CABG provides a consistent survival benefit over PCI with DES.
-
J. Thorac. Cardiovasc. Surg. · May 2024
Meta AnalysisAnatomic, stage-based repair of secondary mitral valve disease.
Intervention for repair of secondary mitral valve disease is frequently associated with recurrent regurgitation. We sought to determine if there was sufficient evidence to support inclusion of anatomic indices of leaflet dysfunction in the management of secondary mitral valve disease. ⋯ For patients with secondary mitral valve disease, satisfactory outcome from valve repair improves when procedural complexity is matched to anatomic indices of leaflet dysfunction. Anatomic indices of leaflet dysfunction should be considered when planning interventions for secondary mitral regurgitation. Routine inclusion of anatomic indices in trial design and reporting should facilitate comparison of results and strengthen guidelines. There are sufficient data to support anatomic staging of secondary mitral valve disease.
-
J. Thorac. Cardiovasc. Surg. · Apr 2024
Meta AnalysisComplete transcatheter versus surgical approach to aortic stenosis with coronary artery disease: A systematic review and meta-analysis.
This meta-analysis aimed to evaluate outcomes of transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) versus surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG). ⋯ In patients with severe aortic stenosis and coronary artery disease, TAVR + PCI was associated with greater all-cause mortality at follow-up compared with SAVR + CABG. Heart Team approach to assess TAVR candidacy remains imperative.
-
J. Thorac. Cardiovasc. Surg. · Mar 2024
Meta AnalysisCoronary artery bypass grafting versus medical therapy in patients with stable coronary artery disease: An individual patient data pooled meta-analysis of randomized trials.
It is unclear whether coronary artery bypass grafting (CABG) improves survival compared with medical therapy (MT) in patients with stable coronary artery disease (CAD). The aim of this analysis was to perform an individual-patient data-pooled meta-analysis of contemporary randomized controlled trials that compared CABG and MT in patients with stable CAD. ⋯ In patients with stable CAD, initial allocation to CABG was associated with greater periprocedural risk of death but improved long-term survival compared with MT. The survival advantage for CABG became significant after the fourth postoperative year and was particularly pronounced in younger and non-White patients.