P012. A Meta-Analysis of Valve Sparing Aortic Root Repair in Patients with Bicuspid Aortic Valve as Compared with Tricuspid Aortic Valve
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Mayo Clinic - Rochester
Rochester, MN
United States - Contact Me
General Surgery Resident, PGY2; Mayo Clinic, Rochester
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective: Valve sparing aortic root repair for the treatment of aortic root dilation with or without aortic dissection has increased recently with studies reporting better outcomes with valve sparing aortic root repair mostly among patients with tricuspid aortic valve. Considering bicuspid aortic valve being an independent risk factor, the role of valve sparing aortic root repair in patients with bicuspid valve is controversial with minimal data. We aim to perform a meta-analysis comparing outcomes of valve sparing aortic root repair in bicuspid as compared with tricuspid aortic valve.
Methods: A systematic, comprehensive search across PUBMED/Medline, SCOPUS, EMBASE, and web of sciences databases was conducted from the inception of the respective database through March 30th, 2023. After screening the retrieved list for duplicates, 2 independent reviewers selected studies meeting our inclusion criteria. The Mantel-Haenszel method with the Paule-Mandel estimator of Tau2 and Hartung-Knapp adjustment for random effect model was utilized to account for interstudy variability and small size effect was utilized to calculate pooled risk ratios (RR) and 95% confidence interval (CI).
Results: A total of 2204 studies were retrieved from our search. Of which, 7 studies were included in our final analysis comprising of 478 patients with bicuspid valve and 715 patients with tricuspid valve. Bicuspid valve as compare with tricuspid was found to have lower risk of short-term outcomes of in-hospital mortality [RR: 0.26, 95% CI 0.13; 0.53] (Figure 1; Panel A) and renal failure [0.49, 95% CI 0.33; 0.73] (Figure 1; Panel E). Bicuspid as compared with tricuspid was found to have similar short outcomes of re-operation for bleeding [0.77, 95% CI 0.44; 1.35] (Figure 1; Panel B), new onset atrial fibrillation [1.10, 95% CI 0.89; 1.36] (Figure 1; Panel C), permanent pacemaker implantation [1.18, 95% CI 0.60; 2.29] (Figure 1; Panel D) and long-term outcomes of overall mortality [0.35, 95% CI 0.10; 1.21], re-operation [1.68, 95% CI 0.74; 3.80] and aortic insufficiency [1.04, 95%CI 0.31; 3.48].
Conclusion: Based on the current results valve sparing aortic repairs in bicuspid as compared with tricuspid aortic valve are associated with comparable short and long outcomes, with indirect evidence suggesting valve sparing aortic valve repair as a feasible option for bicuspid aortic valve.
Authors
Mariam Shariff (1), Ashish Kumar (2), John Stulak (3), Gabor Bagameri (3)
Institutions
(1) Mayo Clinic, United States, (2) Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, (3) Mayo Clinic, Rochester, MN
Methods: A systematic, comprehensive search across PUBMED/Medline, SCOPUS, EMBASE, and web of sciences databases was conducted from the inception of the respective database through March 30th, 2023. After screening the retrieved list for duplicates, 2 independent reviewers selected studies meeting our inclusion criteria. The Mantel-Haenszel method with the Paule-Mandel estimator of Tau2 and Hartung-Knapp adjustment for random effect model was utilized to account for interstudy variability and small size effect was utilized to calculate pooled risk ratios (RR) and 95% confidence interval (CI).
Results: A total of 2204 studies were retrieved from our search. Of which, 7 studies were included in our final analysis comprising of 478 patients with bicuspid valve and 715 patients with tricuspid valve. Bicuspid valve as compare with tricuspid was found to have lower risk of short-term outcomes of in-hospital mortality [RR: 0.26, 95% CI 0.13; 0.53] (Figure 1; Panel A) and renal failure [0.49, 95% CI 0.33; 0.73] (Figure 1; Panel E). Bicuspid as compared with tricuspid was found to have similar short outcomes of re-operation for bleeding [0.77, 95% CI 0.44; 1.35] (Figure 1; Panel B), new onset atrial fibrillation [1.10, 95% CI 0.89; 1.36] (Figure 1; Panel C), permanent pacemaker implantation [1.18, 95% CI 0.60; 2.29] (Figure 1; Panel D) and long-term outcomes of overall mortality [0.35, 95% CI 0.10; 1.21], re-operation [1.68, 95% CI 0.74; 3.80] and aortic insufficiency [1.04, 95%CI 0.31; 3.48].
Conclusion: Based on the current results valve sparing aortic repairs in bicuspid as compared with tricuspid aortic valve are associated with comparable short and long outcomes, with indirect evidence suggesting valve sparing aortic valve repair as a feasible option for bicuspid aortic valve.
Authors
Mariam Shariff (1), Ashish Kumar (2), John Stulak (3), Gabor Bagameri (3)
Institutions
(1) Mayo Clinic, United States, (2) Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, (3) Mayo Clinic, Rochester, MN
Presentation Duration
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