Meta-Analysis of Valve Hemodynamics and Left Ventricular Mass Regression for Stentless Versus Stented Aortic Valves

摘要: Background Stentless aortic bioprostheses have been advocated as being superior to conventional bioprosthetic valves, with benefits including left ventricular mass regression and larger effective orifice area. Several high-quality randomized studies now exist on this topic, we sought summarize them by meta-analysis. Methods The literature was searched from 1995 2006, in MEDLINE, EMBASE, CRISP, metaRegister of Controlled Trials, the Cochrane database. Experts were also contacted reference lists searched. Studies combined using inverse variance fixed-effects model. Heterogeneity assessed a sensitivity analysis performed. Publication bias investigated. Results Ten identified that included 919 patients which Freedom (Sorin Biomedica Cardio, Via Crescentino, Italy), Freestyle (Medtronic, Minneapolis, MN), Prima Plus (Edwards Life Sciences, Irvine, CA) Toronto Biocor (St Jude Medical, St. Paul, MN) valves used. mean valve gradient lower stentless groups, weighted difference (WMD) −3.57 mm Hg (95% confidence interval [CI], −4.36 −2.78; p = 0.02), but improvement disappeared after 12 months (WMD, 1.19; 95% CI, −4.15 6.53; 0.66). increase cross-clamp time 23 minutes, bypass 29 minutes valve. Conclusions This meta-analysis showed provide an improved level at 6 months, reduced gradients, area index, expense 23-minute longer 29-minute time.