Evidence map›Paper›PMID 37479872›Full record

ArticleThe Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology2023

Ross procedure versus pulmonary homograft versus mechanical valve versus bioprosthetic valve versus Ozaki procedure for surgical aortic valve replacement: a frequentist network meta-analysis.

Ahmed K Awad, Dave M Mathew, Peter J Fusco, Kathryn S Varghese, Omar Abdel-Nasser, Ayman K Awad, Peter Giannaris, Serena M Mathew, Adham Ahmed

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In one paragraph

Article in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Ahmed K AwadFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Dave M MathewCity University of New York School of Medicine, 1589 Amsterdam Avenue, New York, NY, 10031, USA.
Peter J FuscoCity University of New York School of Medicine, 1589 Amsterdam Avenue, New York, NY, 10031, USA.
Kathryn S VargheseCity University of New York School of Medicine, 1589 Amsterdam Avenue, New York, NY, 10031, USA.
Omar Abdel-NasserFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Ayman K AwadFaculty of Medicine, El-Galala University, Suez, Egypt.
Peter GiannarisCity University of New York School of Medicine, 1589 Amsterdam Avenue, New York, NY, 10031, USA.
Serena M MathewCity University of New York School of Medicine, 1589 Amsterdam Avenue, New York, NY, 10031, USA.
Adham AhmedCity University of New York School of Medicine, 1589 Amsterdam Avenue, New York, NY, 10031, USA. aahmed018@citymail.cuny.edu.ORCID http://orcid.org/0000-0002-8998-8267
City University of New York · USAin Shams University · EGCity College of New York · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere has been a resurgence in interest regarding the Ross procedure due to recent publications detailing positive long-term outcomes. Conversely, surgical aortic valve replacement (SAVR) with a pulmonary homograft (PH), mechanical (MV), bioprosthetic (BV), or the Ozaki procedure each has its own technical advantages and disadvantages. Therefore, we performed a network meta-analysis (NMA) comparing other alternatives to Ross procedure.

methodsMedical databases were comprehensively searched for studies comparing the Ross procedure with AVR using a PH, MV, BV, or the Ozaki procedure. Outcomes were pooled as risk ratios (RR) with their 95% confidence intervals (95% CI).

resultsA total of 7816 patients were pooled for our NMA from 24 studies. Compared to Ross procedure, both BV and MV were associated with significantly higher rates of 30-day mortality of RR (2.37, 95% CI 1.20-4.67) and (1.88 95% CI 1.04-3.40), respectively, with no significant difference regarding PH or Ozaki. However, only MV was associated with a higher risk of 30-day stroke (RR 8.42, 95% CI 1.57-45.23) with no significant difference in the other alternatives, as well as 30-day MI which showed no significant differences between any of the aortic conduits compared to the Ross procedure. Regarding 30-day major bleeding, MV was associated with a higher when compared to the Ross procedure RR (4.58, 95% CI 1.94-10.85), PH was associated with a lower risk of major bleeding with RR (0.35, 95% CI 0.17-0.71), and BV showed no significant difference. With a mean follow-up duration of 8.5 years compared to the Ross procedure, BV, PH, and MV were associated with a higher risk of long-term mortality with RR (1.89, 95% CI 1.38-2.58), (1.38, 95% CI 1.0-1.87), and (1.94, 95% CI 1.52-2.47), respectively, with the Ozaki procedure showed no significant difference. Regarding long-term stroke-with a mean of 6.3-year follow-up duration-there were no significant differences between any of the aortic conduits compared to the Ross procedure. Nevertheless, long-term need for reintervention-with a mean follow-up duration of 17.5 years-was significant of higher risk with both BV and PH with RR (3.28, 95% CI 1.21-8.84) and (2.42, 95% CI 1.05-5.58), respectively, compared to Ross procedure with MV and Ozaki having no significant difference.

conclusionsThe Ross procedure is a viable treatment option for patients undergoing SAVR, showing promising outcomes at short- and long-term follow-ups.

Indexed as

Aortic valve replacementHomograftMechanical valveRoss procedure

Identifiers

PMID37479872
PMCPMC10361932
OpenAlexW4385064011

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.