Key result
Aortic valve repair yielded similar 1-year mortality to replacement (5.9% vs 9.3%, P=0.77) but a higher 1-year reoperation rate (8.8% vs 3.7%, P=0.03).
Why the study?
Clinical outcomes between aortic valve repair and replacement in patients with aortic regurgitation required systematic comparison.
Does aortic valve repair improve clinical outcomes compared to aortic valve replacement in patients with aortic regurgitation?
Meta-Analysis (n=1,071)
Does aortic valve repair improve clinical outcomes compared to aortic valve replacement in patients with aortic regurgitation?
Absolute Event Rate: 5.9% vs 9.3%
p-value: p=0.77
Aortic valve repair for aortic regurgitation offers comparable short-term mortality to replacement but is associated with a significantly higher 1-year reoperation rate.
Does not support aortic valve repair over replacement to minimize reoperations in aortic regurgitation; leaves open long-term durability in selected patients.
OBJECTIVE: To systematically compare clinical outcomes between aortic valve repair and replacement in patients with aortic regurgitation. METHODS: A comprehensive literature search was undertaken among the four major databases (PubMed, Embase, Scopus, and Ovid) to identify all published data comparing clinical outcomes of aortic valve repair vs replacement. Database searched from inception to November 2018. RESULTS: A total of 1071 patients were analyzed in eight articles. Mean age was similar in both groups of patients (47.2 ± 12.8 vs 48.3 ± 12.7 years, P = 0.83, aortic valve repair and replacement, respectively). The preoperative left ventricular ejection fraction was better in the repair group (56.7% ± 4.8 vs 53.3% ± 4.2, P = 0.005). The rate of moderate-to-severe regurgitation and bicuspid aortic valve were similar in both cohorts (81% vs 78%, P = 0.90% and 58% vs 55%, P = 0.46). In-hospital and 1-year mortality was lower in repair cohort, although not reaching statistical significance (1.3% vs 3.6%, P = 0.12; 5.9% vs 9.3%, P = 0.77). Reoperation rate was higher in repair patients at 1 year (8.8% vs 3.7%, P = 0.03). CONCLUSION: Aortic valve repair offers comparable perioperative outcomes to aortic valve replacement in aortic regurgitation patients at the expense of higher late reintervention rate. Larger trials with long-term follow-up are required to confirm the long-term benefits of aortic valve repair.
No takes yet. Share an insight, caveat, or question.
Wong et al. (2019) conducted a meta-analysis in Aortic regurgitation (n=1,071). Aortic valve repair vs. Aortic valve replacement was evaluated on 1-year mortality (p=0.77). Aortic valve repair yielded similar 1-year mortality to replacement (5.9% vs 9.3%, P=0.77) but a higher 1-year reoperation rate (8.8% vs 3.7%, P=0.03).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: