| Objective:To evaluate the suitability of mitral valve repair(MVP)and mitral valve replacement(MVR)for treating rheumatic heart disease(RHD)and to provide a guideline for clinical treatment.Methods:The Cochrane Library,PubMed,EMbase,CBM,CNKI,VIP,and Wanfang databases has been searched from establishment of the databases to February 2017 for all clinical trials comparing the outcomes of MVP and MVR for RHD.After being organized and evaluated,data was analyzed by using RevMan5.3 statistical software.The 30-day mortality rate,long-term survival,reoperation rates and postoperative complications were evaluated by performing a meta-analysis.Results:There were 11 retrospective studies including 4287 patients(1465 MVP cases and 2822 MVR cases)have been included in the results of meta-analysis,which showed that MVP had improved 30 day mortality(OR=0.51,95%CI:[0.34,0.78],p=0.002),increased long-term survival(HR=0.71,95%CI:[0· 55,0.91],p=0.007),and reduced postoperative complications(HR=0.63,95%CI:(0.50,0.80),p=0.0002).The MVP group had better survival advantage,and the risk of postoperative complications(anticoagulation related bleeding or thromboembolic complications)was lower;however,it had a significantly higher rate of reoperation(HR=2.04,95%CI:[1.71,2.42],p<0.000001).Conclusion:MVP is superior to MVR for short-term and long-term survival and valve-related complications.But it has higher possibility for MVP patients received to suffer from reoperation?... |
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