Minimal Access Aortic Valve Replacement: Is It Worth It?

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Minimal Access Aortic Valve Replacement: Is It Worth It? Bari Murtuza, PhD, FRCS, John R. Pepper, FRCS, Rex DeL Stanbridge, FRCS, Catherine Jones, BSc, MBBS, Christopher Rao, MBBS, Ara Darzi, KBE, FRCS, Thanos Athanasiou, PhD, FETCS The Annals of Thoracic Surgery Volume 85, Issue 3, Pages 1121-1131 (March 2008) DOI: 10.1016/j.athoracsur.2007.09.038 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Overall meta-analysis of perioperative mortality. The diamond represents the summary odds ratio (OR) from the pooled studies with 95% confidence intervals (CIs) and is significant (p ≤ 0.05) if it does not touch the central vertical line (ie, outside the 95% CI). Squares for each included study show point estimates of treatment effect (OR), with the size of the square representing the weight attributed to each study; horizontal bars show 95% CIs for these studies. These results suggest that minimal access aortic valve replacement (mAVR) may have small beneficial effects in terms of mortality. (cAVR = conventional aortic valve replacement; CG = conventional group; df = degrees of freedom; MAG = minimal access group.) The Annals of Thoracic Surgery 2008 85, 1121-1131DOI: (10.1016/j.athoracsur.2007.09.038) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Sensitivity analysis of perioperative mortality. Further analysis using only randomized controlled trials and high-quality nonrandomized studies shows that there is no significant difference in perioperative mortality between the minimal access group (MAG) and the conventional group (CG). (cAVR = conventional aortic valve replacement; CI = confidence interval; df = degrees of freedom; mAVR = minimal access aortic valve replacement; OR = odds ratio.) The Annals of Thoracic Surgery 2008 85, 1121-1131DOI: (10.1016/j.athoracsur.2007.09.038) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions