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- W2897188798 abstract "The aim was to estimate risk of aortic re-operation, and re-operative morbidity and mortality, following replacement of the proximal aorta for aneurysm or dissection. A meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Meta-Analysis of Observational Studies in Epidemiology guidelines. A comprehensive literature review was performed to identify all articles reporting aortic re-operation after proximal aortic replacement. The proximal aorta was defined as extending to the origin of the brachiocephalic trunk. The incidence rate for aortic re-operation (IRAR) was calculated, and stratified based on presence/absence of connective tissue disorders, as well as initial surgical indication. Pooled in hospital mortality and post-operative complication rates were estimated. In total, 7821 patients who underwent proximal aortic replacement from 47 studies were included: 8.3% (n = 649) had Marfan syndrome (MS). During a weighted mean follow up of 4.7 ± 0.3 years, 11.5% (n = 903) underwent aortic re-operation. Mean weighted time between initial surgery and re-operation was 5.2 ± 0.2 years. IRAR was 2.4% per person-year (PPY) (confidence interval [CI] 2.1–2.8%). Patients with MFS had a threefold higher IRAR (6.0% PPY, CI 4.1–8.8%) than did patients without a connective tissue disorders (2.3% PPY, CI 1.9–2.7%; p < .001). IRAR was 2.5% PPY (CI 2.1–3.0%) after operation for dissection and 1.3% PPY (CI 0.9–2.0%) after operation for aneurysm (p = .004 for subgroup differences). IRAR proximal and distal to the left subclavian artery was 1.2% PPY (CI 1.0–1.5%) and 1.3% PPY (CI 1.1–1.6%), respectively. The pooled in hospital mortality and complication rates after re-operation were 14.31% (CI 11.28–17.99%) and 18.08% (CI 10.54–29.25%), respectively. On meta-regression, initial operation for dissection was the only significant predictor of aortic re-operation (beta = .030, p = .001). Aortic re-operation occurs at a mean rate of 2.4% per person-year in the five years after proximal aortic replacement and is strongly associated with initial operation for dissection." @default.
- W2897188798 created "2018-10-26" @default.
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- W2897188798 date "2018-11-01" @default.
- W2897188798 modified "2023-09-27" @default.
- W2897188798 title "Aortic Re-operation After Replacement of the Proximal Aorta: A Systematic Review and Meta-Analysis" @default.
- W2897188798 doi "https://doi.org/10.1016/j.jvs.2018.09.006" @default.
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