Original Article
The clinical recovery of beating heart versus arrested heart techniques for mitral valve replacement surgery: a Meta-analysis
Yi Jing, Duan Hongwei, Gao Hong, Zeng Qingfan, Liu Yanqiu, Zhang Kaiqiang, Wen Chunlei, Sun Long
Published 2018-05-15
Cite as Int J Anesth Resus, 2018, 39(5): 440-446. DOI: 10.3760/cma.j.issn.1673-4378.2018.05.013
Abstract
ObjectiveTo systemically evaluate the clinical recovery differences between beating heart surgery and arrested heart surgery during mitral valve replacement.
MethodsUsing the Cochrane systematic review methods, we searched the Cochrane Controlled Trial Registers(CCTR) of the Cochrane Library, PubMed, EMBASE, CNKI and Wanfang databases concerning the comparison of clinical recovery of beating heart surgery and arrested heart surgery during mitral valve replacement from inception to December 2016. Two reviews independently selected studies and assessed the quality of the trials. Disagreements were resolved by discussion, in consultation with a third reviewer. Then, Meta-analysis was performed using RevMan 5.3 software.
ResultsSeven original randomized controlled trial (RCT) investigated a total of 242 patients, of whom 116 received beating heart surgery and 126 received arrested heart surgery, which met the inclusion criteria. Meta analysis results show that the frequency of defibrillation during operation [odds ratio(OR)=0.10, 95%CI(0.03, 0.29), P<0.05] and usage of vasoactive agents after operation [weighted mean differences (WMD)=-2.71, 95%CI(-3.10, -2.32), P<0.05] were less in beating heart surgery. In addition, the CPB time [WMD=-13.29, 95%CI(-21.97, -4.61), P=0.003] and length of ICU stay [WMD=-7.73, 95%CI(-10.92, -4.54), P<0.05] were shorter in beating heart surgery, as compared to the arrested heart surgery. However, there were no significant differences between the two groups in operative time [WMD=-9.69, 95%CI(-26.15, 6.78), P=0.25], mechanical ventilation time [WMD=-4.39, 95%CI(-10.01, 1.23), P=0.13], post-operatively hospital stay [WMD=-1.12, 95%CI(-2.24, 0.01), P=0.05] and death toll during hospital stay [OR=2.48, 95%CI(0.34, 18.11), P=0.37].
ConclusionsDuring mitral valve replacement, the clinical recovery of beating heart surgery is better than recovery of arrested heart surgery in the frequency of defibrillation, usage of vasoactive agents after operation, CPB time and length of ICU stay. But the operative time, mechanical ventilation time, post-operatively hospital stay and death toll during hospital stay did not show significant differences between the two groups.
Key words:
Cardiac arrest; Mitral valve replacement; Meta-analysis
Contributor Information
Yi Jing
School of Anesthesiology, Guizhou Medical University, Guiyang 550004, China
Duan Hongwei
Department of Anesthesiology, the Affiliated Pudong Hospital of Fudan University, Shanghai 201301, China
Gao Hong
Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Zeng Qingfan
Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Liu Yanqiu
Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
Zhang Kaiqiang
School of Anesthesiology, Guizhou Medical University, Guiyang 550004, China
Wen Chunlei
School of Anesthesiology, Guizhou Medical University, Guiyang 550004, China
Sun Long
Department of Anesthesiology, the Affiliated Pudong Hospital of Fudan University, Shanghai 201301, China
