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Ann Thorac Surg. 2014 Oct;98(4):1499-511. doi: 10.1016/j.athoracsur.2014.05.060. Epub 2014 Jul 24.

A meta-analysis of minimally invasive versus conventional sternotomy for aortic valve replacement.

Author information

1
The Collaborative Research (CORE) Group, Macquarie University, Sydney, New South Wales, Australia.
2
The Collaborative Research (CORE) Group, Macquarie University, Sydney, New South Wales, Australia; Cardiovascular Surgery Department, Sant'Orsola-Malpighi Hospital, Bologna University, Bologna, Italy.
3
The Collaborative Research (CORE) Group, Macquarie University, Sydney, New South Wales, Australia; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. Electronic address: tristanyan@annalscts.com.

Abstract

Minimally invasive aortic valve replacement (AVR) is increasingly used as an alternative to conventional AVR, despite limited randomized evidence available. To assess the evidence base, a systematic search identified 50 comparative studies with a total of 12,786 patients. A meta-analysis demonstrated that minimally invasive AVR is associated with reduced transfusion incidence, intensive care stay, hospitalization, and renal failure, and has a mortality rate that is comparable to conventional AVR. The evidence quality was mostly very low. Given the inadequate statistical power and heterogeneity of available studies, prospective randomized trials are needed to assess the benefits and risks of minimally invasive AVR approaches.

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