ReviewMinimal Access Aortic Valve Replacement: Is It Worth It?
Section snippets
Literature Search
All studies of mAVR were identified from the existing literature up to July 2007. A MEDLINE literature search was performed using the Medical Subject Heading [of the US National Library of Medicine] terms “minimal,” “invasive,” “access,” and “aortic.” For the purpose of this study, “minimal access” was defined as any surgical approach other than a complete median sternotomy or full thoracotomy. A second-level search through reference lists of the included studies was performed to ensure that no
Studies Included in Meta-Analysis
We identified 89 published reports, and of these, 26 comparative studies were included in the present study: four RCTs [3, 4, 5, 6] and 22 retrospective or prospective comparative studies performed between 1998 and 2006 [1, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28]. The total number of patients in these 26 studies was 4,891, with 2,249 in the MAG and 2,642 in the conventional group (CG). Charcteristics of the included studies are shown in Table 1. Ten
Comment
The present study was performed to address two questions: (1) Can the clinical outcomes in patients undergoing AVR be improved using minimal access techniques? and (2) What is the role of mAVR in routine cardiac surgical practice? The meta-analysis performed in this study did not show any significant quantitative differences between mAVR and cAVR for perioperative mortality or other primary outcome events of CVA, renal failure, or respiratory failure. Sensitivity analysis suggested that there
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