Outcome of surgical intervention for aortic root abscess: A meta-analysis

Guan Jhou Chen, Wei Cheng Lo, Hsien Wei Tseng, Sung Ching Pan, Yih Sharng Chen, Shan Chwen Chang

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

OBJECTIVES: Aortic root abscess (ARA) is a catastrophic complication of aortic root endocarditis, involving both native and prosthetic valves, which often warrants surgical intervention. Currently, aortic valve replacement (AVR) and aortic root replacement (ARR) are the most widely employed techniques. However, evidence that directly compares these methods is scarce. In this meta-analysis, we aimed to describe the surgical outcome of ARA when using different surgical methods. METHODS: In this meta-analysis, we performed literature searches in the EMBASE and PubMed databases and reviewed articles describing postoperative results of ARA that were published before 30 June 2016. After extracting the published data, we used a random-effects model to perform meta-analysis and compare the postoperative outcomes of ARA after management with AVR or ARR. RESULTS: Seven published studies were included in this meta-analysis, which includes 781 episodes of infective endocarditis complicated with ARA. There was no significant difference in the 30-day postoperative mortality rate among patients receiving ARR [23.8%, 95% confidence interval (CI) 17.8-30.6] compared with AVR (19.1%, 95% CI 13.3-26.1%), with a relative risk ratio of 1.30 (95% CI 0.84-2.00). However, patients receiving ARR were associated with statistically significant lower rates of reoperation within 1 year (relative risk 0.50, 95% CI 0.26-0.94). CONCLUSIONS: In our meta-analysis, ARR was associated with a 50% risk reduction of reoperation within 1 year among patients with ARA. There was no significant difference in the 30-day postoperative mortality rate between patients receiving ARR and patients receiving AVR; comparison of the long-term outcomes after these 2 procedures warrants further investigation.

Original languageEnglish
Pages (from-to)807-814
Number of pages8
JournalEuropean Journal of Cardio-thoracic Surgery
Volume53
Issue number4
DOIs
Publication statusPublished - Apr 1 2018
Externally publishedYes

Keywords

  • Aortic root replacement
  • Aortic valve replacement
  • Infective endocarditis
  • Periannular abscess
  • Prosthetic valve endocarditis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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