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Published on: December 11, 2017
Early Surgery Versus Conventional Treatment for Asymptomatic Severe Aortic Regurgitation: A Systematic Review and
Edson Gary Moreira Moreira1, Attila Santos Berriel1, Giovanna Paula Macedo De Lacerda Guedes1
1Department of Cardiac Surgery, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil.
Background:
The management of patients with severe asymptomatic aortic regurgitation remains controversial. This systematic review and meta-analysis aimed to assess and compare long-term outcomes between early surgery and conventional treatment (CT) for severe asymptomatic aortic regurgitation in patients with preserved left ventricular systolic function.
Method:
We conducted a systematic search in the EMBASE, PubMed, and Cochrane databases for studies comparing early surgery with CT. The analysed outcome was death from all causes. We evaluated the risk of bias in the included studies using the ROBINS-I (Risk Of Bias In Non-randomised Studies of Interventions) tool.
Results:
Three studies, involving 469 patients, were included. Of the participants studied, 57% underwent early surgery, and 43% underwent CT. Early surgery did significantly reduce all-cause mortality (odds ratio 0.35; 95% confidence interval 0.12-1.00; p=0.05; I2=54%).
Conclusions:
Our study provides evidence supporting the idea that early surgery, in comparison to conservative management, is associated with better long-term outcomes in patients with severe asymptomatic aortic regurgitation and normal ventricular function.
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