PMID- 35665516
OWN - NLM
STAT- MEDLINE
DCOM- 20220719
LR  - 20220720
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 45
IP  - 7
DP  - 2022 Jul
TI  - Mechanical or biologic prostheses for mitral valve replacement: A systematic 
      review and meta-analysis.
PG  - 701-716
LID - 10.1002/clc.23854 [doi]
AB  - Either a mechanical or bioprosthetic valve is used in patients undergoing mitral 
      valve replacement (MVR). However, the optimal mitral prosthesis remains 
      controversial. The aim of this meta-analysis was thus to compare outcomes between 
      mechanical mitral valve replacement (MVRm) and bioprosthetic mitral valve 
      replacement (MVRb) for MVR patients. We searched Embase, PubMed, Web of Science, 
      and Cochrane Library databases from January 1, 2000 to October 31, 2021 for 
      studies that directly compared surgical outcomes of MVRm and MVRb. A total of 22 
      studies with 35 903 patients were included in the meta-analysis (n = 23 868 MVRm 
      and n = 12 035 MVRb). The MVRm group displayed lower long-term all causes 
      mortality (HR, 0.84; 95% confidence interval [CI]: 0.77-0.91; p < .0001; 
      I(2) = 51%), and fewer mitral reoperation (hazard ratio [HR]: 0.34; 95% CI: 
      0.23-0.50; p < .00001; I(2) = 74%) than MVRb group. However, the MVRm group was 
      associated with a greater risk of major bleeding events (HR: 1.21; 95% CI: 
      1.14-1.29; p < .00001; I(2) = 0%), stroke and systemic embolism (HR: 1.20; 95% CI: 
      1.10-1.32; p < .0001; I(2) = 0%) in matched or adjusted data. No significant 
      difference was observed between MVRm and MVRb on operative mortality in 
      matched/adjusted group (risk ratios: 0.83; 95% CI: 0.66-1.05; p = .12; I(2) = 0%). 
      The results were consistent with patients aged under 70 years old. Patients who 
      received a MVRm is associated with 16% lower risk of long-term mortality and 66% 
      lower risk of mitral reoperation, but 20% greater risk of stroke or systemic 
      embolism, 21% greater risk of major bleeding compared with MVRb in 
      matched/adjusted studies group, which were consistent to patients younger than 
      the age of 70 years who underwent MVR.
CI  - (c) 2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
FAU - Yu, Jun
AU  - Yu J
AUID- ORCID: 0000-0001-9823-4726
AD  - Department of Structural Heart Disease, Fu Wai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union 
      Medical College, Beijing, China.
FAU - Qiao, En
AU  - Qiao E
AD  - Department of Structural Heart Disease, Fu Wai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union 
      Medical College, Beijing, China.
FAU - Wang, Wei
AU  - Wang W
AD  - Department of Structural Heart Disease, Fu Wai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union 
      Medical College, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20220605
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Biological Products)
SB  - IM
MH  - Aged
MH  - *Biological Products
MH  - *Bioprosthesis/adverse effects
MH  - *Heart Valve Prosthesis/adverse effects
MH  - *Heart Valve Prosthesis Implantation
MH  - Hemorrhage/etiology
MH  - Humans
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - Reoperation/adverse effects
MH  - Retrospective Studies
MH  - *Stroke/etiology
MH  - Treatment Outcome
PMC - PMC9286334
OTO - NOTNLM
OT  - bioprosthetic
OT  - mechanical
OT  - mitral valve replacement (MVR)
COIS- Authors declare no conflict of interest.
EDAT- 2022/06/07 06:00
MHDA- 2022/07/20 06:00
PMCR- 2022/06/05
CRDT- 2022/06/06 14:34
PHST- 2022/04/25 00:00 [revised]
PHST- 2022/03/05 00:00 [received]
PHST- 2022/05/16 00:00 [accepted]
PHST- 2022/06/07 06:00 [pubmed]
PHST- 2022/07/20 06:00 [medline]
PHST- 2022/06/06 14:34 [entrez]
PHST- 2022/06/05 00:00 [pmc-release]
AID - CLC23854 [pii]
AID - 10.1002/clc.23854 [doi]
PST - ppublish
SO  - Clin Cardiol. 2022 Jul;45(7):701-716. doi: 10.1002/clc.23854. Epub 2022 Jun 5.