Meta analysis of the valve replacement with or without mitral valve structure

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Abstract

OBJECTIVE:

To investigate the efficacy and safety of valve replacement with partly or whole mitral valve structure for treatment of rheumatic mitral valve disease.

METHODS:

Primary screening of the literatures was performed by net and by hand. Randomized control studies regarding the valve replacement with partly or whole mitral valve structure were screened out from Chinese Journal Full-text Database (CNKI: 1998/2008), China BioMedical Literature Database and Weipu Journal Database. The results were involved in Meta analysis. Experimental group underwent valve replacement with mitral valve structure and control group underwent valve replacement without mitral valve structure. The therapeutic effect and difference were evaluated using the odds ratio, weighted mean difference and 95% confidence interval. Statistical analysis was done using Review Manager4.2 software.

RESULTS:

Four randomized control studies performed in China were involved. Meta analysis result have showed that there was no significant difference in the postoperative death rate between two groups [RR 0.34, 95% CI (0.27, 0.61), P > 0.05]; The left ventricular internal diameter was both reduced in two groups after operation, especially in the experimental group [RR 6.10, 95%CI (3.37, 8.83), P < 0.000 1]. The experimental group was superior to control group with regard to the ejection fraction, cardiac index and stroke volume before and after operation. Severe adverse effect was absent in related reports.

CONCLUSION:

The valve replacement with partly or whole mitral valve structure can improve the ventricular internal diameter, ejection fraction, cardiac index and stroke volume, thus improving cardiac function. However, bicuspid valve restenosis should be avoided through active observation.

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