PDF(Pubmed)
Abstract：
UNASSIGNED: The safety and efficacy of different surgical repairs of supravalvar aortic stenosis (SVAS) are inconsistent.
UNASSIGNED: To compare the prognosis of single-, two- and three-patch repair for patients with SVAS.
UNASSIGNED: PubMed, EMBASE, Cochrane Library, Web of Science, and clinicaltrials.gov were searched until April 17, 2022.
UNASSIGNED: Study reported SVAS patients treated with single-, two- or three-patch repair.
UNASSIGNED: Two reviewers independently extracted the data of study characteristics and clinical outcomes. Multiple pairwise and frequentist network meta-analyses were conducted. And a fixed-effect model was used when no heterogeneity existed.
UNASSIGNED: Outcomes included the rate of reintervention, aortic insufficiency, early mortality and late mortality, cardiopulmonary bypass (CPB) time, cross-clamping (CCP) time, and postoperative/ follow-up pressure gradient. Binary variables were evaluated by odds ratio (OR) and its 95% confidence interval (CI), while continuous variables were assessed by standardized mean difference (SMD) and its 95% CI.
UNASSIGNED: Twenty-seven retrospective cohort studies were included, comprising 1,162 patients, undergoing single-patch (46.6% of cases), two-patch (33.9%), and three-patch repair (19.4%). Two-patch method had a lower rate of reintervention compared with single-patch (OR = 0.47, 95 % CI 0.28-0.89), and three-patch (OR = 0.31, 95 % CI 0.15-0.64). This finding also applied to juvenile and non-Asian patients. Three-patch method had a lower rate of aortic insufficiency compared with single-patch (OR = 0.11, 95 % CI 0.01-0.63), and two-patch (OR = 0.11, 95 % CI 0.02-0.83). But this repair had the longest CCP time, which was significantly longer than that of single- (SMD = 0.76, 95 % CI 0.36-1.17) or two-patch repair (SMD = 0.61, 95 % CI 0.06-1.16). No significant difference was found in mortality and pressure gradient among three procedures.
UNASSIGNED: Two-patch repair has the lowest reintervention rate and relatively reasonable operation time. Complex and severe SVAS is suggested to be treated with two-patch repair. Further prospective studies of a reasonable sample size will be required with a special focus on the use of different patch materials and surgeons\' unique working experience.
UNASSIGNED: http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022328146.
UNASSIGNED: To compare the prognosis of single-, two- and three-patch repair for patients with SVAS.
UNASSIGNED: PubMed, EMBASE, Cochrane Library, Web of Science, and clinicaltrials.gov were searched until April 17, 2022.
UNASSIGNED: Study reported SVAS patients treated with single-, two- or three-patch repair.
UNASSIGNED: Two reviewers independently extracted the data of study characteristics and clinical outcomes. Multiple pairwise and frequentist network meta-analyses were conducted. And a fixed-effect model was used when no heterogeneity existed.
UNASSIGNED: Outcomes included the rate of reintervention, aortic insufficiency, early mortality and late mortality, cardiopulmonary bypass (CPB) time, cross-clamping (CCP) time, and postoperative/ follow-up pressure gradient. Binary variables were evaluated by odds ratio (OR) and its 95% confidence interval (CI), while continuous variables were assessed by standardized mean difference (SMD) and its 95% CI.
UNASSIGNED: Twenty-seven retrospective cohort studies were included, comprising 1,162 patients, undergoing single-patch (46.6% of cases), two-patch (33.9%), and three-patch repair (19.4%). Two-patch method had a lower rate of reintervention compared with single-patch (OR = 0.47, 95 % CI 0.28-0.89), and three-patch (OR = 0.31, 95 % CI 0.15-0.64). This finding also applied to juvenile and non-Asian patients. Three-patch method had a lower rate of aortic insufficiency compared with single-patch (OR = 0.11, 95 % CI 0.01-0.63), and two-patch (OR = 0.11, 95 % CI 0.02-0.83). But this repair had the longest CCP time, which was significantly longer than that of single- (SMD = 0.76, 95 % CI 0.36-1.17) or two-patch repair (SMD = 0.61, 95 % CI 0.06-1.16). No significant difference was found in mortality and pressure gradient among three procedures.
UNASSIGNED: Two-patch repair has the lowest reintervention rate and relatively reasonable operation time. Complex and severe SVAS is suggested to be treated with two-patch repair. Further prospective studies of a reasonable sample size will be required with a special focus on the use of different patch materials and surgeons\' unique working experience.
UNASSIGNED: http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022328146.
摘要：
UNASSIGNED：对瓣上主动脉瓣狭窄（SVAS）进行不同手术修复的安全性和有效性不一致。
未经批准：比较单发疾病的预后SVAS患者的两片和三片修复。
未经授权：PubMed，EMBASE,科克伦图书馆,WebofScience,和clinicaltrials.gov被搜索到2022年4月17日。
未经评估：研究报告SVAS患者接受单，两个或三个补丁修复。
UNASSIGNED：两名评审员独立提取研究特征和临床结果的数据。进行了多对和频繁的网络荟萃分析。当不存在异质性时，使用固定效应模型。
未经评估：结果包括再干预率，主动脉瓣关闭不全,早期死亡率和晚期死亡率，体外循环(CPB)时间,交叉夹紧（CCP）时间，和术后/随访压力梯度。二元变量通过比值比(OR)及其95%置信区间(CI)进行评估，而连续变量通过标准化均差(SMD)及其95%CI进行评估。
未经评估：纳入了27项回顾性队列研究，包括1,162名患者，接受单贴片(46.6%的病例)，两片(33.9%)，和三片修复(19.4%)。与单贴剂相比，双贴剂方法的再干预率较低（OR=0.47，95％CI0.28-0.89），和三片（OR=0.31，95%CI0.15-0.64）。这一发现也适用于青少年和非亚洲患者。与单补片相比，三补片方法的主动脉瓣关闭不全发生率较低（OR=0.11，95％CI0.01-0.63），和两片（OR=0.11，95%CI0.02-0.83）。但是这次修复的时间最长，显着长于单补片（SMD=0.76，95％CI0.36-1.17）或双补片修复（SMD=0.61，95％CI0.06-1.16）。在三个程序中，死亡率和压力梯度没有发现显着差异。
UNASSIGNED：两片修复的再干预率最低，手术时间相对合理。复杂和严重的SVAS建议进行两次补片修复。需要对合理样本量进行进一步的前瞻性研究，特别关注使用不同的贴片材料和外科医生独特的工作经验。
UNASSIGNED:http://www。crd.约克。AC.英国/PROSPERO/,标识符：CRD42022328146。
未经批准：比较单发疾病的预后SVAS患者的两片和三片修复。
未经授权：PubMed，EMBASE,科克伦图书馆,WebofScience,和clinicaltrials.gov被搜索到2022年4月17日。
未经评估：研究报告SVAS患者接受单，两个或三个补丁修复。
UNASSIGNED：两名评审员独立提取研究特征和临床结果的数据。进行了多对和频繁的网络荟萃分析。当不存在异质性时，使用固定效应模型。
未经评估：结果包括再干预率，主动脉瓣关闭不全,早期死亡率和晚期死亡率，体外循环(CPB)时间,交叉夹紧（CCP）时间，和术后/随访压力梯度。二元变量通过比值比(OR)及其95%置信区间(CI)进行评估，而连续变量通过标准化均差(SMD)及其95%CI进行评估。
未经评估：纳入了27项回顾性队列研究，包括1,162名患者，接受单贴片(46.6%的病例)，两片(33.9%)，和三片修复(19.4%)。与单贴剂相比，双贴剂方法的再干预率较低（OR=0.47，95％CI0.28-0.89），和三片（OR=0.31，95%CI0.15-0.64）。这一发现也适用于青少年和非亚洲患者。与单补片相比，三补片方法的主动脉瓣关闭不全发生率较低（OR=0.11，95％CI0.01-0.63），和两片（OR=0.11，95%CI0.02-0.83）。但是这次修复的时间最长，显着长于单补片（SMD=0.76，95％CI0.36-1.17）或双补片修复（SMD=0.61，95％CI0.06-1.16）。在三个程序中，死亡率和压力梯度没有发现显着差异。
UNASSIGNED：两片修复的再干预率最低，手术时间相对合理。复杂和严重的SVAS建议进行两次补片修复。需要对合理样本量进行进一步的前瞻性研究，特别关注使用不同的贴片材料和外科医生独特的工作经验。
UNASSIGNED:http://www。crd.约克。AC.英国/PROSPERO/,标识符：CRD42022328146。
