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Heart valve prosthesis selection in patients with end-stage renal disease requiring dialysis: a systematic review and meta-analysis

ContextThere is little evidence guiding heart valve prosthesis selection in patients with end-stage renal disease (ESRD) on dialysis.ObjectivesTo perform: 1) a systematic review of studies examining valve replacement in patients with ESRD on dialysis; and 2) a quantitative meta-analysis comparing su... Full description

Journal Title: Heart (British Cardiac Society) 2011-12, Vol.97 (24), p.2033-91
Main Author: Chan, Vincent
Other Authors: Chen, Li , Mesana, Laura , Mesana, Thierry G , Ruel, Marc
Format: Electronic Article Electronic Article
Language: English
Subjects:
VHD
Quelle: Alma/SFX Local Collection
Publisher: London: BMJ Publishing Group Ltd and British Cardiovascular Society
ID: ISSN: 1355-6037
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title: Heart valve prosthesis selection in patients with end-stage renal disease requiring dialysis: a systematic review and meta-analysis
format: Article
creator:
  • Chan, Vincent
  • Chen, Li
  • Mesana, Laura
  • Mesana, Thierry G
  • Ruel, Marc
subjects:
  • Abridged Index Medicus
  • Biological and medical sciences
  • Bioprosthesis
  • cardiac surgery
  • Cardiology. Vascular system
  • cardiopulmonary bypass
  • cardiovascular surgery
  • Catheters
  • coronary bypass surgery
  • Failure
  • Heart
  • Heart Valve Diseases - complications
  • Heart Valve Diseases - mortality
  • Heart Valve Diseases - surgery
  • Heart Valve Prosthesis
  • Hemodialysis
  • Humans
  • Kidney diseases
  • Kidney Failure, Chronic - complications
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - therapy
  • Medical sciences
  • Meta-analysis
  • mitral regurgitation
  • mitral valve prolapse
  • Nephrology. Urinary tract diseases
  • Nephropathies. Renovascular diseases. Renal failure
  • Prognosis
  • Prostheses
  • Prosthesis Design
  • prosthetic heart valves
  • Renal Dialysis - methods
  • Renal failure
  • statistics
  • Studies
  • surgery (adult)
  • surgery CAD
  • surgery-coronary bypass
  • surgery-valve
  • surgery-valves
  • Survival Rate
  • Thromboembolism
  • Valvular disease
  • valvular heart disease
  • VHD
ispartof: Heart (British Cardiac Society), 2011-12, Vol.97 (24), p.2033-91
description: ContextThere is little evidence guiding heart valve prosthesis selection in patients with end-stage renal disease (ESRD) on dialysis.ObjectivesTo perform: 1) a systematic review of studies examining valve replacement in patients with ESRD on dialysis; and 2) a quantitative meta-analysis comparing survival and valve-related outcomes following valve replacement with bioprostheses versus mechanical prostheses in this population.Data sourcesEnglish studies published from 1990 onwards.Study selectionStudies were included in the meta-analysis if they compared bioprostheses with mechanical prostheses in patients with ESRD on dialysis.Data extractionExtracted summary estimates included the hazard ratio (HR) for death, and the odds ratio (OR) for developing valve-related complications due to the use of bioprostheses versus mechanical prosthesis.ResultsTwelve studies published from 1997 to 2010 were included in this review, of which 9 were used in the meta-analysis. No evidence of publication bias was detected. The aortic valve was the most common valve replaced in these studies (4339/6350), although 11 of the 12 studies also included mitral or multiple valve replacements. No difference in survival was observed between valve types (bioprostheses versus mechanical prostheses hazard ratio 1.3, 95% confidence interval (CI) 1.0-1.9, p=0.09). However, valve replacement with bioprostheses was associated with fewer valve-related complications compared to mechanical prostheses (odds ratio 0.4, 95% CI 0.2-0.7, p=0.002).ConclusionsA meta-analysis of the published literature demonstrates no survival difference following valve replacement with either bioprostheses or mechanical prosthesis in patients with ESRD on dialysis. Bioprosthetic valve replacement was associated with fewer valve-related complications. Although this meta-analysis cannot discriminate between the sites of valve implant, these data can likely be extended to include at least aortic valve replacement.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titleHeart valve prosthesis selection in patients with end-stage renal disease requiring dialysis: a systematic review and meta-analysis
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creatorChan, Vincent ; Chen, Li ; Mesana, Laura ; Mesana, Thierry G ; Ruel, Marc
creatorcontribChan, Vincent ; Chen, Li ; Mesana, Laura ; Mesana, Thierry G ; Ruel, Marc
descriptionContextThere is little evidence guiding heart valve prosthesis selection in patients with end-stage renal disease (ESRD) on dialysis.ObjectivesTo perform: 1) a systematic review of studies examining valve replacement in patients with ESRD on dialysis; and 2) a quantitative meta-analysis comparing survival and valve-related outcomes following valve replacement with bioprostheses versus mechanical prostheses in this population.Data sourcesEnglish studies published from 1990 onwards.Study selectionStudies were included in the meta-analysis if they compared bioprostheses with mechanical prostheses in patients with ESRD on dialysis.Data extractionExtracted summary estimates included the hazard ratio (HR) for death, and the odds ratio (OR) for developing valve-related complications due to the use of bioprostheses versus mechanical prosthesis.ResultsTwelve studies published from 1997 to 2010 were included in this review, of which 9 were used in the meta-analysis. No evidence of publication bias was detected. The aortic valve was the most common valve replaced in these studies (4339/6350), although 11 of the 12 studies also included mitral or multiple valve replacements. No difference in survival was observed between valve types (bioprostheses versus mechanical prostheses hazard ratio 1.3, 95% confidence interval (CI) 1.0-1.9, p=0.09). However, valve replacement with bioprostheses was associated with fewer valve-related complications compared to mechanical prostheses (odds ratio 0.4, 95% CI 0.2-0.7, p=0.002).ConclusionsA meta-analysis of the published literature demonstrates no survival difference following valve replacement with either bioprostheses or mechanical prosthesis in patients with ESRD on dialysis. Bioprosthetic valve replacement was associated with fewer valve-related complications. Although this meta-analysis cannot discriminate between the sites of valve implant, these data can likely be extended to include at least aortic valve replacement.
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1EISSN: 1468-201X
2DOI: 10.1136/heartjnl-2011-300727
3PMID: 21990382
languageeng
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subjectAbridged Index Medicus ; Biological and medical sciences ; Bioprosthesis ; cardiac surgery ; Cardiology. Vascular system ; cardiopulmonary bypass ; cardiovascular surgery ; Catheters ; coronary bypass surgery ; Failure ; Heart ; Heart Valve Diseases - complications ; Heart Valve Diseases - mortality ; Heart Valve Diseases - surgery ; Heart Valve Prosthesis ; Hemodialysis ; Humans ; Kidney diseases ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - therapy ; Medical sciences ; Meta-analysis ; mitral regurgitation ; mitral valve prolapse ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Prognosis ; Prostheses ; Prosthesis Design ; prosthetic heart valves ; Renal Dialysis - methods ; Renal failure ; statistics ; Studies ; surgery (adult) ; surgery CAD ; surgery-coronary bypass ; surgery-valve ; surgery-valves ; Survival Rate ; Thromboembolism ; Valvular disease ; valvular heart disease ; VHD
ispartofHeart (British Cardiac Society), 2011-12, Vol.97 (24), p.2033-91
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descriptionContextThere is little evidence guiding heart valve prosthesis selection in patients with end-stage renal disease (ESRD) on dialysis.ObjectivesTo perform: 1) a systematic review of studies examining valve replacement in patients with ESRD on dialysis; and 2) a quantitative meta-analysis comparing survival and valve-related outcomes following valve replacement with bioprostheses versus mechanical prostheses in this population.Data sourcesEnglish studies published from 1990 onwards.Study selectionStudies were included in the meta-analysis if they compared bioprostheses with mechanical prostheses in patients with ESRD on dialysis.Data extractionExtracted summary estimates included the hazard ratio (HR) for death, and the odds ratio (OR) for developing valve-related complications due to the use of bioprostheses versus mechanical prosthesis.ResultsTwelve studies published from 1997 to 2010 were included in this review, of which 9 were used in the meta-analysis. No evidence of publication bias was detected. The aortic valve was the most common valve replaced in these studies (4339/6350), although 11 of the 12 studies also included mitral or multiple valve replacements. No difference in survival was observed between valve types (bioprostheses versus mechanical prostheses hazard ratio 1.3, 95% confidence interval (CI) 1.0-1.9, p=0.09). However, valve replacement with bioprostheses was associated with fewer valve-related complications compared to mechanical prostheses (odds ratio 0.4, 95% CI 0.2-0.7, p=0.002).ConclusionsA meta-analysis of the published literature demonstrates no survival difference following valve replacement with either bioprostheses or mechanical prosthesis in patients with ESRD on dialysis. Bioprosthetic valve replacement was associated with fewer valve-related complications. Although this meta-analysis cannot discriminate between the sites of valve implant, these data can likely be extended to include at least aortic valve replacement.
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0Abridged Index Medicus
1Biological and medical sciences
2Bioprosthesis
3cardiac surgery
4Cardiology. Vascular system
5cardiopulmonary bypass
6cardiovascular surgery
7Catheters
8coronary bypass surgery
9Failure
10Heart
11Heart Valve Diseases - complications
12Heart Valve Diseases - mortality
13Heart Valve Diseases - surgery
14Heart Valve Prosthesis
15Hemodialysis
16Humans
17Kidney diseases
18Kidney Failure, Chronic - complications
19Kidney Failure, Chronic - mortality
20Kidney Failure, Chronic - therapy
21Medical sciences
22Meta-analysis
23mitral regurgitation
24mitral valve prolapse
25Nephrology. Urinary tract diseases
26Nephropathies. Renovascular diseases. Renal failure
27Prognosis
28Prostheses
29Prosthesis Design
30prosthetic heart valves
31Renal Dialysis - methods
32Renal failure
33statistics
34Studies
35surgery (adult)
36surgery CAD
37surgery-coronary bypass
38surgery-valve
39surgery-valves
40Survival Rate
41Thromboembolism
42Valvular disease
43valvular heart disease
44VHD
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abstractContextThere is little evidence guiding heart valve prosthesis selection in patients with end-stage renal disease (ESRD) on dialysis.ObjectivesTo perform: 1) a systematic review of studies examining valve replacement in patients with ESRD on dialysis; and 2) a quantitative meta-analysis comparing survival and valve-related outcomes following valve replacement with bioprostheses versus mechanical prostheses in this population.Data sourcesEnglish studies published from 1990 onwards.Study selectionStudies were included in the meta-analysis if they compared bioprostheses with mechanical prostheses in patients with ESRD on dialysis.Data extractionExtracted summary estimates included the hazard ratio (HR) for death, and the odds ratio (OR) for developing valve-related complications due to the use of bioprostheses versus mechanical prosthesis.ResultsTwelve studies published from 1997 to 2010 were included in this review, of which 9 were used in the meta-analysis. No evidence of publication bias was detected. The aortic valve was the most common valve replaced in these studies (4339/6350), although 11 of the 12 studies also included mitral or multiple valve replacements. No difference in survival was observed between valve types (bioprostheses versus mechanical prostheses hazard ratio 1.3, 95% confidence interval (CI) 1.0-1.9, p=0.09). However, valve replacement with bioprostheses was associated with fewer valve-related complications compared to mechanical prostheses (odds ratio 0.4, 95% CI 0.2-0.7, p=0.002).ConclusionsA meta-analysis of the published literature demonstrates no survival difference following valve replacement with either bioprostheses or mechanical prosthesis in patients with ESRD on dialysis. Bioprosthetic valve replacement was associated with fewer valve-related complications. Although this meta-analysis cannot discriminate between the sites of valve implant, these data can likely be extended to include at least aortic valve replacement.
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pubBMJ Publishing Group Ltd and British Cardiovascular Society
pmid21990382
doi10.1136/heartjnl-2011-300727