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Transthoracic clamp versus endoaortic balloon occlusion in minimally invasive mitral valve surgery: a systematic review and meta-analysis.


ABSTRACT: This systematic review and meta-analysis aims to determine outcomes following aortic occlusion with the transthoracic clamp (TTC) versus endoaortic balloon occlusion (EABO) in patients undergoing minimally invasive mitral valve surgery. A subgroup analysis compares TTC to EABO with femoral cannulation separately from EABO with aortic cannulation. We searched Medline and Embase up to December 2018. Two people independently and in duplicate screened title and abstracts, full-text reports, extracted data and assessed the risk of bias using the Cochrane risk-of-bias tool for non-randomized studies. We identified 1564 reports from which 11 observational studies with 4181 participants met the inclusion criteria. We found no evidence of difference in the risk of postoperative death or cerebrovascular accident (CVA) between the 2 techniques. Evidence for a reduction in aortic dissection with TTC was found: 4 of 1590 for the TTC group vs 19 of 2492 for the EABO group [risk ratio 0.33, 95% confidence interval (CI) 0.12-0.93; P?=?0.04]. There was no difference in aortic cross-clamp (AoX) time between TTC and EABO [mean difference (MD) -5.17?min, 95% CI -12.40 to 2.06; P?=?0.16]. TTC was associated with a shorter AoX time compared to EABO with femoral cannulation (MD -9.26?min, 95% CI -17.00 to -1.52; P?=?0.02). EABO with aortic cannulation was associated with a shorter AoX time compared to TTC (MD 7.77?min, 95% CI 3.29-12.26; P?

SUBMITTER: Rival PM 

PROVIDER: S-EPMC6751412 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Transthoracic clamp versus endoaortic balloon occlusion in minimally invasive mitral valve surgery: a systematic review and meta-analysis.

Rival Paul Martin PM   Moore Theresa H M THM   McAleenan Alexandra A   Hamilton Hamish H   Du Toit Zachary Z   Akowuah Enoch E   Angelini Gianni D GD   Vohra Hunaid A HA  

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 20191001 4


This systematic review and meta-analysis aims to determine outcomes following aortic occlusion with the transthoracic clamp (TTC) versus endoaortic balloon occlusion (EABO) in patients undergoing minimally invasive mitral valve surgery. A subgroup analysis compares TTC to EABO with femoral cannulation separately from EABO with aortic cannulation. We searched Medline and Embase up to December 2018. Two people independently and in duplicate screened title and abstracts, full-text reports, extracte  ...[more]

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