Department of Biosurgery and Surgical Technology, Imperial College London, 10th Floor QEQM Building, St Mary's Hospital, London W2 1NY, UK.
Heart Lung Circ. 2011 Sep;20(9):555-65. doi: 10.1016/j.hlc.2011.03.012. Epub 2011 Apr 16.
A literature review was undertaken according to Cochrane guidelines to identify whether mitral valve repair (MV-Repair) or replacement (MV-Replacement) is more effective in patients with moderate to severe ischaemic mitral regurgitation. The literature suggests MV-Repair may have improved 30-day mortality and long-term survival. All 12 studies identified, however, were non-randomised, retrospective, and at significant risk of bias due to heterogeneous surgical techniques and mismatched patient characteristics. Data describing the need for reoperation were not sufficiently well reported to analyse. Functional outcomes and health-related quality of life were not reported. In conclusion, high-quality randomised comparison of MV-Repair and MV-Replacement is urgently needed.
根据 Cochrane 指南进行了文献回顾,以确定在中重度缺血性二尖瓣反流患者中,二尖瓣修复(MV-Repair)或置换(MV-Replacement)更有效。文献表明,MV-Repair 可能改善了 30 天死亡率和长期生存率。然而,所有确定的 12 项研究都是非随机的、回顾性的,由于手术技术的异质性和患者特征的不匹配,存在显著的偏倚风险。没有充分报告需要再次手术的数据,因此无法进行分析。没有报告功能结果和与健康相关的生活质量。总之,迫切需要对 MV-Repair 和 MV-Replacement 进行高质量的随机比较。