Evidence map›Paper›PMID 41071046›Full record

SynthesisInterdisciplinary cardiovascular and thoracic surgery2025

Comparative Study of Different Minimally Invasive Aortic Valve Replacement Techniques: A Systematic Review and Network Meta-Analysis.

Theresia Feline Husen, Ananda Pipphali Vidya, Samuel Heuts, Alfian Prasetyo, Aqilla Katrita Zaira Nugroho, Roberto Lorusso, Elham Bidar, Bart Maesen, Peyman Sardari Nia

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Theresia Feline HusenDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, 6229 HX, Netherlands.ORCID 0000-0001-6901-1435
Ananda Pipphali VidyaFaculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia.ORCID 0000-0003-1732-5277
Samuel HeutsDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, 6229 HX, Netherlands.ORCID 0000-0003-3531-9997
Alfian PrasetyoFaculty of Medicine, University Atma Jaya, Jakarta, 14440, Indonesia.ORCID 0009-0003-9522-9472
Aqilla Katrita Zaira NugrohoFaculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia.ORCID 0009-0008-9410-5597
Roberto LorussoDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, 6229 HX, Netherlands.ORCID 0000-0002-1777-2045
Elham BidarDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, 6229 HX, Netherlands.ORCID 0000-0002-9569-4900
Bart MaesenDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, 6229 HX, Netherlands.ORCID 0000-0001-8622-1450
Peyman Sardari NiaDepartment of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, 6229 HX, Netherlands.ORCID 0000-0003-2296-1497

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis investigation aimed to compare different minimally invasive techniques, namely, mini-sternotomy (MS), mini-thoracotomy (MT), and totally thoracoscopic (TT) approaches for the surgical treatment of aortic valve disease, emphasizing their respective benefits and limitations to guide clinical decision-making.

methodsA systematic search was conducted in Medline, Web of Science, Scopus, Wiley Online Library, Google Scholar, and ProQuest. Studies were appraised using the Newcastle-Ottawa Scale. A frequentist network meta-analysis (NMA) with a random-effects model was employed to give reflective ranks and compare outcomes across techniques. Treatment ranking was based on p-scores, with MS as the reference. Higher p-scores indicate greater certainty of superiority over competing interventions. The primary outcome was mortality.

resultsTwenty-five observational studies (n = 34 573 patients) were included. Mortality did not differ between techniques (p-score: MS [0.85] ∼ MT [0.34] ∼ TT [0.31]). TT had longer cardiopulmonary bypass (mean difference [MD]: 41.04 [95% CI, 10.98-71.10]) and cross-clamp times (MD: 30.31 [95% CI, 5.81-54.80]) but offered the shortest intensive care unit (ICU) length of stay (p-score: TT [0.98] > MT [0.51] > MS [0.01]; MD: -16.00 [95% CI, -26.62 to -5.38]), reduced hospital stay (MD: -2.07 [95% CI, -3.77 to -0.37]), and fewer complications, including neurological events (odds ratio: 1.79 [95% CI, 1.03-3.13]), blood loss (MD: 208.85 mL [95% CI, 102.29-315.40]) compared to MS. MT showed similar outcomes to MS, except for longer operative times (MD: 29.84 [95% CI, 8.35-51.32]) and shorter ICU stays (MD: -5.88 [95% CI, -11.10 to -0.67]).

conclusionsTT may offer advantages such as shorter hospital stays, reduced neurological complications, and less bleeding as compared to MS, although it is associated with longer operative times. However, as all included studies were observational, the findings should be interpreted with caution, and further NMA including only randomized trials is warranted.

Indexed as

Aortic ValveAortic Valve DiseaseHeart Valve Prosthesis ImplantationSternotomyThoracoscopyThoracotomyHumansLength of StayMinimally Invasive Surgical ProceduresPostoperative ComplicationsRisk FactorsTreatment Outcomeaortic valvemini-sternotomymini-thoracotomyreplacementtotally thoracoscopic

Identifiers

PMID41071046
PMCPMC12619574

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.