Meta-analysis of open surgical repair versus hybrid arch repair for aortic arch aneurysm

Ling, Miao; Song, Lei; Sun, Shengkai; Wang, Zhenguo

doi:10.1093/icvts/ivw305

Cited by 31 publications

(29 citation statements)

References 16 publications

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“…While the present results agree with findings from similar analyses (11,35), it is worth noting the significant degree of heterogeneity seen across almost all results. The I 2 CIs were often wide and sensitivity analysis revealed heterogeneity was often largely contributed to by a minority of studies (7,19,20).…”

Section: Discussionsupporting

confidence: 88%

“…Recent systematic reviews and meta-analyses have examined these series and present differences in short-term outcomes between open and hybrid aortic arch repair (HAR) techniques (10)(11)(12) and for hybrid techniques generally (13,14). This review aims to examine long-term survival outcomes from comparative studies and to conduct a metaanalysis of short-term outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term survival and related outcomes for hybrid versus traditional arch repair—a meta-analysis

Chakos¹,

Jbara²,

Yan³

et al. 2018

Ann. Cardiothorac. Surg.

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Background: Surgical interventions for aortic aneurysm and dissection remain associated with high risk of mortality and morbidity. Advances in operative techniques have led to a variety of options for the cardiac surgeon, including endovascular and hybrid approaches. Debate remains over which of these techniques provide optimal outcomes for the patient. The present systematic review and meta-analysis aims to evaluate long term patient survival and identify short-term outcomes for conventional (open) aortic arch repair and hybrid aortic arch repair (HAR).Methods: An electronic literature search was conducted according to predefined inclusion criteria for hybrid and conventional aortic arch repair surgery. Digitized survival data was extracted from identified studies' Kaplan-Meier curves and used to re-create individual patient data for aggregated survival analysis.Post-operative morbidity and mortality were analyzed using random-effects model meta-analysis.Results: Nine studies were included, containing 841 hybrid arch repair and 1,182 conventional arch repair patients. Pooled Kaplan-Meier analysis of all patients demonstrated higher survival in hybrid arch repair patients than conventional arch repair patients, however, this was noted to be sensitive to results from a particular study. Overall results showed for the hybrid repair cohort, survival at 1, 2, 3, 5 and 7 years was 87%, 85%, 83%, 78% and 75%, respectively. Survival in the conventional repair cohort at 1, 2, 3, 5 and 7 years was 84%, 82%, 80%, 75% and 71%, respectively. Statistically significant findings from meta-analysis showed hybrid arch repair was associated with lower risk of re-operation for bleeding, while conventional arch repair was associated with reduced risk of spinal cord injury.Conclusions: Pooled Kaplan-Meier analysis of all studies showed long-term survival outcomes for hybrid and conventional aortic arch repair patients are heterogeneous and sensitive to the results of particular studies. Superior results from particular centres and the low number of comparative studies mean that more data is required to make definitive findings with regards to the long-term survival outcomes of either procedure. Hybrid arch repair was associated with lower risk of re-operation for bleeding, while conventional arch repair was associated with lower risk of spinal cord injury. Surgeons should consider their own center's experience and patient suitability when deciding between hybrid or conventional aortic repair techniques.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Long-term survival and related outcomes for hybrid versus traditional arch repair—a meta-analysis

Chakos¹,

Jbara²,

Yan³

et al. 2018

Ann. Cardiothorac. Surg.

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“…Recently hybrid repair was recommended as a viable option for higher risk patients. 4,10,11 Chimney and fenestration techniques have been used to treat aortic arch diseases, and the short-and mid-term results are favourable. 12e14 However, the risk of endoleak from chimney and fenestration techniques is much higher in theory.…”

Section: Discussionmentioning

confidence: 99%

A Feasibility Study of a New Unibody Branched Stent Graft Applied to Reconstruct the Canine Aortic Arch

Zhai

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…12 Reintervention rates are also higher than with open repair. 13 To whom this category of hybrid arch repair should be offered remains controversial. We reserve its use in patients with hostile resternotomies and severe comorbidities such as advanced cardiopulmonary disease.…”

Section: Distal Arch/proximal Dtasmentioning

confidence: 99%

The Evolving Role of Hybrid Arch Repair

Chung

Ouzounian

Chu

et al. 2020

Innovations�(Phila)

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Meta-analysis of open surgical repair versus hybrid arch repair for aortic arch aneurysm

Cited by 31 publications

References 16 publications

Long-term survival and related outcomes for hybrid versus traditional arch repair—a meta-analysis

Long-term survival and related outcomes for hybrid versus traditional arch repair—a meta-analysis

A Feasibility Study of a New Unibody Branched Stent Graft Applied to Reconstruct the Canine Aortic Arch

The Evolving Role of Hybrid Arch Repair

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