The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Aug 2020
Meta AnalysisLevosimendan Reduces Mortality and Low Cardiac Output Syndrome in Cardiac Surgery.
There has been conflicting evidence concerning the effect of levosimendan on clinical outcomes in patients undergoing cardiac surgery. Therefore, we performed a systematic review and conducted this meta-analysis to provide evidence for/against the administration of levosimendan in cardiac surgery patients. ⋯ Our meta-analysis suggests beneficial effects for the prophylactic use of levosimendan in patients with severely impaired left ventricular function undergoing cardiac surgery. The administration of levosimendan was associated with a reduced mortality, less LCOS, and restored adequate organ perfusion reflected in less acute kidney injury.
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Thorac Cardiovasc Surg · Apr 2020
Meta AnalysisTopical Use of Tranexamic Acid in Cardiac Surgery: A Meta-Analysis.
This meta-analysis was conducted to investigate the evidence for the efficacy and safety of intrapericardial tranexamic acid (TXA) in cardiac surgery. ⋯ Findings from this meta-analysis suggest that intrapericardial use of TXA in patients undergoing cardiac surgery can decrease postoperative bleeding without increasing the risk of postoperative seizures. Future large randomized, double-blind, controlled clinical trials are needed to confirm these promising findings.
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Thorac Cardiovasc Surg · Jun 2019
Review Meta AnalysisMeta-analysis of Valve-in-Valve Transcatheter versus Redo Surgical Aortic Valve Replacement.
The objective of this study was to determine whether valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) is associated with better survival than redo surgical aortic valve replacement (SAVR) in patients with degenerated aortic valve bioprostheses, and we performed a meta-analysis of comparative studies. ⋯ In patients with degenerated aortic valve bioprostheses, especially elderly or high-risk patients, VIV-TAVI could be a safe, feasible alternative to redo SAVR. The lack of randomized data and differences in baseline characteristics in the present analysis emphasize the need for prospective randomized trials.
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Thorac Cardiovasc Surg · Jun 2019
Meta AnalysisSurvival after Aortic Valve Replacement with Bovine or Porcine Valve Prostheses: A Systematic Review and Meta-Analysis.
Bovine and porcine bioprostheses are commonly used for surgical aortic valve replacement. It is unknown if the long-term survival differs between the two valve types.We performed a systematic review and meta-analysis to compare survival in patients who underwent aortic valve replacement and received a bovine or a porcine prosthesis. ⋯ This systematic review and meta-analysis suggest no difference in survival between patients who received a bovine versus a porcine bioprosthesis after aortic valve replacement. Our study provides valuable evidence for the continuing use of both bovine and porcine bioprosthetic valves for surgical aortic valve replacement.
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Thorac Cardiovasc Surg · Sep 2017
Review Meta AnalysisSurgical Repair of Moderate Ischemic Mitral Regurgitation-A Systematic Review and Meta-analysis.
Introduction Moderate mitral regurgitation (MR) of ischemic etiology has been associated with worse outcomes after coronary artery bypass grafting (CABG). Studies comparing concomitant mitral valve replacement/repair (MVR/Re) with CABG and standalone CABG have reported conflicting results. We performed a systematic review and meta-analysis of the published literature. ⋯ MD of change from baseline in left ventricular (LV) end-systolic dimension (MD: - 2.50, 95% CI: - 5.21 to - 0.21, p = 0.071) and LV ejection fraction (MD: 0.48, 95% CI: - 2.48 to 3.44, p = 0.750) were not significantly different between the groups. Incidence of moderate MR (MH RR: 3.24, 95% CI: 1.79-5.89, p < 0.001) was higher in the CABG only group. Conclusion Addition of MVR/Re to CABG in patients with moderate ischemic MR did not result in improvement in early or overall mortality, stroke risk, or intermediate markers of LV function when compared with CABG alone.