• 作者：Aart Mookhoek ; MD^a ; ^{a.mookhoek@erasmusmc.nl" class="auth_mail" title="E-mail the corresponding author} ; Nelleke M. Korteland^a ; Bardia Arabkhani ; MD^a ; Isabelle Di Centa ; MD^b ; Emmanuel Lansac ; MD ; PhD^c ; Jos A. Bekkers ; MD ; PhD^a ; Ad J.J.C. Bogers ; MD ; PhD^a ; Johanna J.M. Takkenberg ; MD ; PhD^a
• 刊名：The Annals of Thoracic Surgery
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：101
• 期：5
• 页码：1684-1689
• 全文大小：298 K

Methods

We conducted a systematic review and meta-analysis of characteristics of and long-term outcome after the Bentall procedure with a mechanical valve prosthesis. Pooling was performed using the inverse variance method within a random-effects model. Outcome events are reported as linearized occurrence rates (percentage per patient year) with 95% confidence intervals.

Results

In total, 46 studies with 7,629 patients (mean age, 50 years; 76% men) were selected. Pooled early mortality was 6% (422 patients). During a mean follow-up of 6 years (49,175 patient-years), the annual linearized occurrence rate for late mortality was 2.02% (1.77%– 2.31%; 892 patients), for aortic root reoperation it was 0.46% (0.36%–0.59%), for hemorrhage it was 0.64% (0.47%–0.87%), for thromboemboli it was 0.77% (0.60%–1.00%), for endocarditis it was 0.39% (0.33%–0.46%), and for major adverse valve-related events it was 2.66% (2.17%–3.24%). Operations performed in more recent years were associated with lower rates of aortic root reoperation (beta = –0.452; m>pm> = 0.015).

Conclusions

This systematic review illustrates that rates of aortic root reoperation after the Bentall procedure have decreased over the years. However, late mortality, major bleeding, and thromboembolic complications remain a concern. This report may be used to benchmark the potential therapeutic benefit of novel surgical approaches, such as valve-sparing aortic root replacement.