Mitral valve repair and replacement in infectious endocarditis: a systematic review and meta-analysis of clinical outcome

Mitral valve repair and replacement in infectious endocarditis: a systematic review and meta-analysis of clinical outcome

Background Infective endocarditis (IE) poses significant clinical challenges, often necessitating surgical intervention for improved patient outcomes. The choice between mitral valve repair (MVP) and mitral valve replacement (MVR) is crucial in managing IE. This systematic review and meta-analysis a...

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Bibliographic Details
Published in:The Egyptian heart journal Vol. 76; no. 1; pp. 134 - 11
Main Authors: Nuthalapati, Umesh, Bathinapattla, Manoj Reddy, Cardoso, Rayner Peyser, Jesi, Nusrat Jahan, Singh, Kanwarmandeep, Moradi, Iman, Gostomczyk, Karol, Afzal, Maham, Omer, Moosa Bin, Mian, Zorez Rashid, Patel, Soham, Sachdeva, Pratyush, Malik, Muhammad Nauman, Abbas, Mohammad, Singh, Jugraj, Shafique, Muhammad Ashir
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 04-10-2024
Springer
Springer Nature B.V
SpringerOpen
Subjects:
Cardiology
Data analysis
Endocarditis
Heart valve diseases
India
Infective endocarditis
Medical colleges
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Meta-analysis
Mitral valve repair
Mitral valve replacement
Mortality
Observational studies
Ostomy
Outcomes
Pakistan
Patient outcomes
Prostheses
Review
Surgery
Systematic review
Pakistan
India
Italy
Netherlands
United Kingdom > UK
Thailand
United States > US
Taiwan
Infective endocarditis
Mitral valve repair
Outcomes
Mitral valve replacement
Meta-analysis
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Summary:Background Infective endocarditis (IE) poses significant clinical challenges, often necessitating surgical intervention for improved patient outcomes. The choice between mitral valve repair (MVP) and mitral valve replacement (MVR) is crucial in managing IE. This systematic review and meta-analysis aims to compare the effectiveness of MVP and MVR in treating IE, focusing on outcomes such as postoperative bleeding, mortality, recurrent endocarditis, and stroke. Main text A comprehensive literature search was conducted following PRISMA guidelines. Studies directly comparing MVP and MVR in IE patients were included. Data extraction and quality assessment were performed, and meta-analysis was conducted using RevMan software. Thirty-two studies involving 82,123 patients were included. MVP was associated with significantly lower rates of postoperative bleeding (OR: 0.58, 95% CI: 0.40–0.84) and reduced long-term mortality (OR: 0.40, 95% CI: 0.32–0.51) compared to MVR. However, MVR showed lower rates of recurrent endocarditis. MVP was also associated with a decreased likelihood of postoperative stroke (OR: 0.52, 95% CI: 0.40–0.68).2, 4 Conclusions MVP demonstrates advantages over MVR in reducing postoperative bleeding, long-term mortality, and stroke risk in IE patients. However, individual patient factors and surgical expertise must be considered in treatment decisions. Further research, including randomized controlled trials, is needed to validate these findings and refine treatment algorithms for IE management.
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ISSN:2090-911X
1110-2608
2090-911X
DOI:10.1186/s43044-024-00564-5