Western University, Schulich School of Medicine and Dentistry, Department of Anesthesia and Perioperative Medicine, London, Canada.
Western University, Schulich School of Medicine and Dentistry, Department of Anesthesia and Perioperative Medicine, London, Canada.
Braz J Anesthesiol. 2022 May-Jun;72(3):379-397. doi: 10.1016/j.bjane.2022.03.002. Epub 2022 Mar 14.
We aimed to examine the recent evidence and search for novel assessments on intraoperative TEE following mitral valve repair that can impact short and long-term outcomes.
The Ovid MEDLINE, PubMed, and EMBASE databases were searched from January 1, 2008, until January 27, 2021, for studies on patients with severe Mitral Valve Regurgitation (MR) undergoing Mitral Valve (MV) repair surgery with intraoperative Transesophageal Echocardiography (TEE) performed after the repair. Additional searches were conducted using Google search engine, Web of Science, and Cochrane Library.
After reviewing 302 records, 8 retrospective and 22 prospective studies were included (n = 30). Due to clinical and methodological diversity, these studies are noncomparable and data were not amenable to quantitative synthesis.
Although technological advances allowed the objective assessment of geometric and dynamic alterations of the MV, the impact of the use of these technologies on short- or long-term outcomes was not studied. There is uncertainty and conflicting evidence on the ideal method and metrics to evaluate MV patency post-repair. Few isolated studies validated methods to assess coaptation surface and LV function post-repair.
我们旨在检查二尖瓣修复术后即时经食管超声心动图（TEE）的最新证据，并寻找可能影响短期和长期结局的新评估方法。
从 2008 年 1 月 1 日至 2021 年 1 月 27 日，我们在 Ovid MEDLINE、PubMed 和 EMBASE 数据库中检索了关于接受二尖瓣修复术的严重二尖瓣反流（MR）患者的研究，术中在修复后进行经食管超声心动图（TEE）。还使用谷歌搜索引擎、Web of Science 和 Cochrane Library 进行了额外的搜索。
在回顾了 302 份记录后，纳入了 8 项回顾性研究和 22 项前瞻性研究（n=30）。由于临床和方法学的多样性，这些研究不可比，数据不适于进行定量综合。
尽管技术进步允许对二尖瓣的几何和动力学变化进行客观评估，但这些技术的使用对短期或长期结局的影响尚未研究。关于修复后评估二尖瓣通畅的理想方法和指标存在不确定性和相互矛盾的证据。少数孤立的研究验证了评估修复后瓣叶对合面和左心室功能的方法。
