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Review
. 2023 Jan 6:9:1048036.
doi: 10.3389/fsurg.2022.1048036. eCollection 2022.

Clinical outcomes following surgical mitral valve plasty or replacement in patients with infectious endocarditis: A meta-analysis

Song Wang  1   2 , Ting Zhou  3 , Jinhui Bian  2 , Geng Li  4 , Wenjing Zhang  5   6 , Si Chen  4 , Yefan Jiang  2   4
Affiliations
Review

Clinical outcomes following surgical mitral valve plasty or replacement in patients with infectious endocarditis: A meta-analysis

Song Wang et al. Front Surg. .

Erratum in

Abstract

Background: For degenerative mitral disease, more and more evidences support that mitral valve plasty (MVP) has much better clincial outcomes than mitral valve replacement (MVR). However, the advantages of MVP in patients suffering from infectious endocarditis (IE) are unclear. To evaluate the appropriateness of MVP in IE patients, we conducted this meta-analysis. Based on the difference between active and healed phase, we not only compared the result of patients with IE, but also identified the subgroup with active IE.

Methods: We systematically searched the clinical trials comparing clinical outcomes of MVP and MVR in patients suffering from IE. Relevant articles were searched from January 1, 2000 to March 18, 2021 in Pubmed and Cochrane Library. Studies were excluded if they were with Newcastle-Ottawa Scale (NOS) score less than 6 or lacking of direct comparisons between MVP and MVR.

Results: 23 studies were involved and 25,615 patients were included. Pooled analysis showed fewer adverse events and early or long-term death in the MVP group. However, more reoperations existed in this patient group. And the reinfection rate was close between two groups. Similar results were observed after identifying active IE subgroup, but there is no difference in the freedom from reoperation due to all-events.

Conclusions: Although limitimations exited in this study, patients suffering from IE can benefit from both MVP and MVR. For surgeons with consummate skills, MVP can be the preferred choice for suitable IE patients.

Keywords: clinical outcomes; infectious endocarditis; meta-analysis; mitral valve plasty; mitral valve replacement.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The flowchart outlining the literature search process.
Figure 2
Figure 2
Meta-analysis for early mortality: (A) MVP vs. MVR; (B) MVP vs. MVR (active IE); MVP, mitral valve plasty; MVR, mitral valve replacement.
Figure 3
Figure 3
Meta-analysis for long-term survival: (A) MVP vs. MVR; (B) MVP vs. MVR (active IE); MVP, mitral valve plasty; MVR, mitral valve replacement.
Figure 4
Figure 4
Meta-analysis for event-free survival: (A) MVP vs. MVR; (B) MVP vs. MVR (active IE); MVP, mitral valve plasty; MVR, mitral valve replacement.
Figure 5
Figure 5
Meta-analysis for freedom from reoperation due to all-events: (A) MVP vs. MVR; (B) MVP vs. MVR (active IE); MVP, mitral valve plasty; MVR, mitral valve replacement.
Figure 6
Figure 6
Meta-analysis for reinfection events between MVP and MVR; (A) MVP vs. MVR; (B) MVP vs. MVR (active IE); MVP, mitral valve plasty; MVR, mitral valve replacement.
See this image and copyright information in PMC

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