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机械瓣与生物瓣主动脉瓣置换术的长期结局：一项系统评价和荟萃分析

Long-Term Outcomes of Mechanical Versus Bioprosthetic Aortic Valve Replacement: A Systematic Review and Meta-Analysis.

作者信息

Vankayalapati Dilip K, Segun-Omosehin Omotayo, El Ghazal Nour, Suresh Daniel Rohan, El Haddad Joe, Mansour Rania, Yap Nathanael, Miangul Shahid, Nakanishi Hayato, Than Christian A

机构信息

General Surgery, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, GBR.

Cardiothoracic Surgery, St George's University of London, London, GBR.

出版信息

Cureus. 2024 Jan 19;16(1):e52550. doi: 10.7759/cureus.52550. eCollection 2024 Jan.

DOI:10.7759/cureus.52550
PMID:38371071
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10870098/
Abstract

This study aimed to investigate the safety and efficacy of bioprosthetic (BV) versus mechanical valves (MV) on long-term outcomes in 50- to 70-year-old aortic stenosis (AS) patients. A literature search for articles published until April 2023 yielded 13 eligible studies, with 15,320 patients divided into BV (n = 7,320) and MV (n = 8,000) cohorts. The review was registered prospectively with PROSPERO (CRD42021278777). MV demonstrated a favorable hazard ratio (HR: 1.12, 95% CI: 1.00-1.25, I= 60%) and higher survival rates at 5 (OR:1.13, 95% CI: 1.02-1.25, I= 42%) and 10 years (OR: 1.13, 95% CI: 1.05-1.23, I= 0%). At 15 years, stroke incidence was comparable (OR: 1.12, 95% CI: 0.98-1.27, I= 4%). BV showed lower bleeding events (OR: 1.7, 95% CI: 1.18-2.46, I= 88%), but MV replacement showed lower reoperation incidence (OR: 0.27, 95% CI: 0.18-0.42, I= 85%). MV appears favorable for the long-term approach in AS management compared to BV.

摘要

本研究旨在调查生物瓣膜（BV）与机械瓣膜（MV）对50至70岁主动脉瓣狭窄（AS）患者长期预后的安全性和有效性。检索截至2023年4月发表的文章，共获得13项符合条件的研究，15320例患者被分为BV组（n = 7320）和MV组（n = 8000）。该综述已在PROSPERO（CRD42021278777）上进行前瞻性注册。MV显示出有利的风险比（HR：1.12，95%CI：1.00 - 1.25，I = 60%），在5年（OR：1.13，95%CI：1.02 - 1.25，I = 42%）和10年（OR：1.13，95%CI：1.05 - 1.23，I = 0%）时生存率更高。在15年时，中风发生率相当（OR：1.12，95%CI：0.98 - 1.27，I = 4%）。BV显示出血事件较低（OR：1.7，95%CI：1.18 - 2.46，I = 88%），但MV置换显示再次手术发生率较低（OR：0.27，95%CI：0.18 - 0.42，I = 85%）。与BV相比，MV似乎更有利于AS管理的长期治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/c2879b597793/cureus-0016-00000052550-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/89d03db74139/cureus-0016-00000052550-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/e2aa374edfa3/cureus-0016-00000052550-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/3a3c693e772b/cureus-0016-00000052550-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/1dbebd148d82/cureus-0016-00000052550-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/deee0906436e/cureus-0016-00000052550-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/58acb311968f/cureus-0016-00000052550-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/46da856fe6dd/cureus-0016-00000052550-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/1f8c00bbba63/cureus-0016-00000052550-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/c2879b597793/cureus-0016-00000052550-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/89d03db74139/cureus-0016-00000052550-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/e2aa374edfa3/cureus-0016-00000052550-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/3a3c693e772b/cureus-0016-00000052550-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/1dbebd148d82/cureus-0016-00000052550-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/deee0906436e/cureus-0016-00000052550-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/58acb311968f/cureus-0016-00000052550-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/46da856fe6dd/cureus-0016-00000052550-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/1f8c00bbba63/cureus-0016-00000052550-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4795/10870098/c2879b597793/cureus-0016-00000052550-i09.jpg

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