Ross Operation in Neonates: A Meta-analysis
Ross Operation in Neonates: A Meta-analysis
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DOI：
10.1016/j.athoracsur.2020.11.008
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发表时间：
2021-12-09
影响因子：
4.6
通讯作者：
Sainathan, Sandeep
中科院分区：
文献类型：
--
作者：
Rajab, Taufiek Konrad;Zorrilla-Vaca, Andres;Sainathan, Sandeep
背景。罗斯手术是儿童主动脉瓣置换术的首选治疗方法。然而之前的研究表明新生儿的结局很差。这项荟萃分析检查了新生儿罗斯手术的汇总结果。方法。从成立到 2020 年 5 月 1 日，我们对四个主要数据库（PubMed/MEDLINE、EMBASE、Scopus 和 ScienceDirect）进行了检索，以查找描述新生儿罗斯手术结果的研究。主要结局是早期死亡率，次要结局是晚期死亡率和机械支持。使用随机效应模型来解释研究之间可能存在的异质性，并使用连续性校正来包括零总事件试验。结果。分析中纳入了 18 项研究，其中包含 181 名新生儿的结果数据。荟萃分析显示，合并早期死亡率为 24%（95% 置信区间，12%-38%；I-2 = 52%，异质性 P = .01）。荟萃回归分析显示，最近发表的研究报告早期死亡率显着恶化 (P = .03)。术后机械支持的汇总发生率为 15%（95% 置信区间，5%-28%；I-2 = 28%，异质性 P = .22）。根据 Egger 检验，没有发现发表偏倚的证据（偏倚系数 = 0.21，P = .57）。结论。新生儿罗斯手术的早期死亡率很高。新生儿不可修复主动脉瓣的治疗仍然是先天性心脏手术中尚未解决的问题。 (C) 2022 胸外科医师协会
Background. The Ross operation is the preferred treatment for aortic valve replacement in children. However previous studies indicate that outcomes in neonates are poor. This meta-analysis examines the pooled outcomes of the Ross operation in neonates.Methods. Four major databases (PubMed/MEDLINE, EMBASE, Scopus, and ScienceDirect) were searched from inception until May 1, 2020 for studies describing outcomes of the Ross operation in neonates. The primary outcome was early mortality, and secondary outcomes were late mortality and mechanical support. Random-effects models were used to account for possible heterogeneity between studies, and continuity corrections were used to include zero total event trials.Results. Eighteen studies comprising outcomes data on 181 neonates were included in the analysis. Meta-analysis showed a pooled early mortality rate of 24% (95% confidence interval, 12%-38%; I-2 = 52%, P for heterogeneity = .01). Meta-regression analysis showed that more recently published studies reported significantly worse early mortality (P = .03). The pooled incidence of postoperative mechanical support was 15% (95% confidence interval, 5%-28%; I-2 = 28%, P for heterogeneity = .22). No evidence of publication bias was found according to Egger's test (bias coefficient = 0.21, P = .57).Conclusions. The neonatal Ross operation carries a high early mortality rate. The treatment of unrepairable aortic valves in neonates remains an unsolved problem in congenital cardiac surgery. (C) 2022 by The Society of Thoracic Surgeons