经导管主动脉瓣置换术治疗二叶式主动脉瓣狭窄与三叶式主动脉瓣狭窄疗效比较的meta分析

郑五强; 祖秀光; 张少娟

doi:10.13201/j.issn.1001-1439.2020.11.012

经导管主动脉瓣置换术治疗二叶式主动脉瓣狭窄与三叶式主动脉瓣狭窄疗效比较的meta分析

- 河北医科大学第二医院心内三科(石家庄, 050000)

详细信息

通讯作者: 祖秀光,E-mail:zxg100109@163.com

中图分类号: R543.1

收稿日期: 2020-04-13

Comparing outcomes after transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis and tricuspid aortic valve stenosis: a Meta-analysis

- Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China

More Information

Corresponding author: ZU Xiuguang, E-mail: zxg100109@163.com

Received Date: 13 April 2020

摘要

摘要: 目的:系统评价经导管主动脉瓣置换术治疗二叶式主动脉瓣狭窄与三叶式主动脉瓣狭窄的疗效。方法:检索建库至2020年2月PubMed、Embase、Cochrane图书馆、万方数据库和中国知网的随机对照及队列研究试验,同时采用Revman 5.3、Stata 15.1软件对纳入试验进行荟萃分析。结果:纳入17项研究,共分析132333例患者。荟萃分析结果显示:BAV组与TAV组在30 d死亡率(OR=1.13,95%CI:0.89~1.44,P=0.32)、1年死亡率(OR=0.91,95%CI:0.77~1.06,P=0.22)、脑卒中(OR=1.26,95%CI:0.94~1.68,P=0.12)、瓣周漏(OR=1.17,95%CI:0.95~1.44,P=0.15)、大出血事件(OR=0.84,95%CI:0.66~1.06,P=0.13)、血管并发症(OR=0.77,95%CI:0.59~1.00,P=0.051)、冠脉阻塞(OR=1.83,95%CI:0.93~3.60,P=0.08)、术后心梗(OR=1.14,95%CI:0.63~2.06,P=0.66)、急性肾损伤(OR=1.02,95%CI:0.76~1.37,P=0.89)术后并发症方面差异无统计学差异。在手术成功率(OR=0.59,95%CI:0.39~0.94,P=0.03)上低于TAV组。中转开胸(OR=2.88,95%CI:1.61~5.18,P=0.0004)及起搏器植入(OR=1.17,95%CI:1.02~1.33,P=0.02)方面高于TAV组。结论:与TAV患者相比,BAV患者行TAVR治疗是可行的、有效的。两组的死亡率以及主要术后并发症无统计学差异。但BAV组在手术成功率上低于TAV组,中转开胸、新发起搏器植入事件高于TAV组,应该在新一代生物瓣膜中行进一步研究。
- 主动脉瓣狭窄 /
- 二叶式主动脉瓣 /
- 经导管主动脉瓣置换术 /
- 荟萃分析
Abstract: Objective: To evaluate the efficacy of transcatheter aortic valve replacement in the treatment of bicuspid aortic valve stenosis or tricuspid aortic valve stenosis. Method: The randomized controlled and cohort trials were searched in Pubmed, Embase, Cochrane Library, Wanfang Database and China knowledge Network. At the same time, the inclusion trials were meta-analyzed by Revman 5.3 software. Result: The 17 studies were included and a total of 132333 patients were analyzed. The results of meta-analysis showed that there was no statistical difference in the 30-day mortality(OR=1.13, 95%CI: 0.89—1.44, P=0.32), 1-year mortality(OR=0.91, 95%CI: 0.77—1.06, P=0.22), stroke(OR=1.26, 95%CI: 0.94—1.68, P=0.12), paravalvular leakage(OR=1.17, 95%CI: 0.95—1.44, P=0.15), major bleeding(OR=0.84, 95%CI: 0.66—1.06, P=0.13), vascular complication(OR=0.77, 95%CI: 0.59—1.00, P=0.051), coronary artery obstruction(OR=1.83, 95%CI: 0.93—3.60, P=0.08), myocardial infarction(OR=1.14, 95%CI: 0.63—2.06, P=0.66) and AKI(OR=1.02, 95%CI: 0.76—1.37, P=0.89) between The two groups. The surgical success rate(OR=0.59, 95%CI: 0.39—0.94, P=0.03) in the BAV group was lower than that in the TAV group. The events of conversion to surgery(OR=2.88, 95%CI: 1.61—5.18, P=0.0004) and pacemaker implantation(OR=1.17, 95%CI: 1.02—1.33, P=0.02) in the BAV group were higher than those in the TAV group. Conclusion: Compared with TAV, the application of TAVR in BAV patients is feasible and effective. There was no statistical difference in the mortality and major postoperative complications in two groups. The surgical success rate in the BAV group was lower than that in the TAV group. The events of conversion to surgery and pacemaker implantation in the BAV group were higher than those in the TAV group.
- aortic stenosis /
- bicuspid aortic valve /
- transcatheter aortic valve replacement /
- meta-analysis

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