■非老年人的最佳主动脉瓣替代品仍存在争议。最近,关于罗斯手术的大量数据已经积累。本研究旨在使用对事件发生时间结果的荟萃分析,从当前文献中分析Ross程序后的长期结果。
■使用MEDLINE进行了文献检索,EMBASE,科克伦图书馆,WebofScience,和GoogleScholar至2022年6月;报告罗斯手术超过20年的临床结果的研究被纳入分析。感兴趣的结果是晚期生存和免于自体移植物或右心室流出道(RVOT)的手术或经皮再介入。
■六项研究,包括4,910名患者(3,601名男性),被识别和分析。5、10、15、20年生存率为99.9%±0.1%,97.6%±0.5%,94.3%±0.9%,和87.4%±1.9%。5年、10年、15年和20年自体移植再干预的自由度为97.7%±0.5%,95.3%±0.7%,91.4%±1.2%,84.8%±2.5%。RVOT再干预的自由度为99.0%±0.3%,99.0%±0.3%,97.5%±0.7%,93.3%±1.8%。5、10、15和20年时无任何瓣膜再介入(自体移植或RVOT)的发生率为95.8%±0.6%,92.6%±0.9%,88.5%±1.2%,80.8%±2.5%。
■这项荟萃分析表明,尽管在20年时约有20%的患者需要自体移植或RVOT的再干预,但Ross手术仍可提供出色的生存率。
UNASSIGNED: The optimal aortic valve substitute for non-elderly adults remains controversial. Recently, considerable data on the Ross procedure have accumulated. This study aimed to analyze long-term outcomes following the Ross procedure from the current literature using a meta-analysis of time-to-event outcomes.
UNASSIGNED: A literature search was performed with MEDLINE, EMBASE, Cochrane Library, Web of Science, and Google Scholar through June 2022; studies reporting clinical outcomes of the Ross procedure beyond 20 years were included for analysis. The outcomes of interest were late survival and freedom from surgical or percutaneous reintervention of the autograft or right ventricular outflow tract (RVOT).
UNASSIGNED: Six studies, including 4,910 patients (3,601 males), were identified and analyzed. Survival rate at 5, 10, 15, and 20 years was 99.9%±0.1%, 97.6%±0.5%, 94.3%±0.9%, and 87.4%±1.9%. Freedom from autograft reintervention at 5, 10, 15, and 20 years was 97.7%±0.5%, 95.3%±0.7%, 91.4%±1.2%, 84.8%±2.5%. Freedom from RVOT reintervention was 99.0%±0.3%, 99.0%±0.3%, 97.5%±0.7%, 93.3%±1.8%. Freedom from any valve reintervention (either autograft or RVOT) at 5, 10, 15, and 20 years was 95.8%±0.6%, 92.6%±0.9%, 88.5%±1.2%, 80.8%±2.5%.
UNASSIGNED: This meta-analysis demonstrated that the Ross procedure was confirmed to provide excellent survival despite the need for reintervention of autograft or RVOT in approximately 20% of patients at 20 years.