Key result
The Cabrol procedure and its modifications demonstrated acceptable outcomes, with a pooled all-cause early mortality of 9.0% and a linearized late mortality rate of 3.63% per patient-year.
Why the study?
The Cabrol procedure has undergone various modifications since its invention, but there was a notable gap in the literature regarding meta-analyses assessing it.
What are the long-term outcomes and complication rates of the Cabrol procedure and its modifications in patients requiring aortic root surgery?
Meta-Analysis (n=833)
What are the long-term outcomes and complication rates of the Cabrol procedure and its modifications in patients requiring aortic root surgery?
The Cabrol procedure and its modifications demonstrate acceptable long-term outcomes regarding mortality and complications, particularly given its frequent use in complex cases and reoperations.
Supports Cabrol use in complex reoperations; extends prior reviews with first pooled long-term linearized rates.
BACKGROUND: The Cabrol procedure has undergone various modifications and developments since its invention. However, there is a notable gap in the literature regarding meta-analyses assessing it. METHODS: A systematic review and meta-analysis was conducted to evaluate the effectiveness and long-term outcomes of the Cabrol procedure and its modifications. Pooling was conducted using random effects model. Outcome events were reported as linearized occurrence rates (percentage per patient-year) with 95% confidence intervals. RESULTS: A total of 14 studies involving 833 patients (mean age: 50.8 years; 68.0% male) were included in this meta-analysis. The pooled all-cause early mortality was 9.0% (66 patients), and the combined rate of reoperation due to bleeding was 4.9% (17 patients). During the average 4.4-year follow-up (3,727.3 patient-years), the annual occurrence rates (linearized) for complications were as follows: 3.63% (2.79-4.73) for late mortality, 0.64% (0.35-1.16) for aortic root reoperation, 0.57% (0.25-1.31) for hemorrhage events, 0.66% (0.16-2.74) for thromboembolism, 0.60% (0.29-1.26) for endocarditis, 2.32% (1.04-5.16) for major valve-related adverse events, and 0.58% (0.34-1.00) for Cabrol-related coronary graft complications. CONCLUSION: This systematic review provides evidence that the outcomes of the Cabrol procedure and its modifications are acceptable in terms of mortality, reoperation, anticoagulation, and valve-related complications, especially in Cabrol-related coronary graft complications. Notably, the majority of Cabrol procedures were performed in reoperations and complex cases. Furthermore, the design and anastomosis of the Dacron interposition graft for coronary reimplantation, considering natural anatomy and physiological hemodynamics, may promise future advancements in this field.
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Yang et al. (2024) conducted a meta-analysis in Aortic root disease (n=833). Cabrol procedure and its modifications was evaluated on Late mortality (linearized occurrence rate per patient-year) (95% CI 2.79-4.73). The Cabrol procedure and its modifications demonstrated acceptable outcomes, with a pooled all-cause early mortality of 9.0% and a linearized late mortality rate of 3.63% per patient-year.
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