Comparative Study of Different Minimally Invasive Aortic Valve Replacement Techniques: A Systematic Review and Network Meta-Analysis Article Swipe
Theresia Feline Husen
,
Ananda Pipphali Vidya
,
Samuel Heuts
,
Adzana Yasadhy Hangga Prasetyo
,
Adianto Nugroho
,
Roberto Lorusso
,
Elham Bidar
,
Bart Maesen
,
Peyman Sardari Nia
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/icvts/ivaf244
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/icvts/ivaf244
Objectives This investigation aimed to compare different minimally invasive techniques, namely, mini-sternotomy (MS), mini-thoracotomy (MT), and totally thoracoscopic (TT) approaches for the surgical treatment of aortic valve disease, emphasizing their respective benefits and limitations to guide clinical decision-making. Methods A systematic search was conducted in Medline, Web of Science, Scopus, Wiley Online Library, Google Scholar, and ProQuest. Studies were appraised using the Newcastle-Ottawa Scale. A frequentist network meta-analysis (NMA) with a random-effects model was employed to give reflective ranks and compare outcomes across techniques. Treatment ranking was based on p-scores, with MS as the reference. Higher p-scores indicate greater certainty of superiority over competing interventions. The primary outcome was mortality. Results Twenty-five observational studies (n = 34 573 patients) were included. Mortality did not differ between techniques (p-score: MS [0.85] ∼ MT [0.34] ∼ TT [0.31]). TT had longer cardiopulmonary bypass (mean difference [MD]: 41.04 [95% CI, 10.98-71.10]) and cross-clamp times (MD: 30.31 [95% CI, 5.81-54.80]) but offered the shortest intensive care unit (ICU) length of stay (p-score: TT [0.98] > MT [0.51] > MS [0.01]; MD: −16.00 [95% CI, −26.62 to −5.38]), reduced hospital stay (MD: −2.07 [95% CI, −3.77 to −0.37]), and fewer complications, including neurological events (odds ratio: 1.79 [95% CI, 1.03-3.13]), blood loss (MD: 208.85 mL [95% CI, 102.29-315.40]) compared to MS. MT showed similar outcomes to MS, except for longer operative times (MD: 29.84 [95% CI, 8.35-51.32]) and shorter ICU stays (MD: −5.88 [95% CI, −11.10 to −0.67]). Conclusions TT may offer advantages such as shorter hospital stays, reduced neurological complications, and less bleeding as compared to MS, although it is associated with longer operative times. However, as all included studies were observational, the findings should be interpreted with caution, and further NMA including only randomized trials is warranted.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1093/icvts/ivaf244
- https://academic.oup.com/icvts/advance-article-pdf/doi/10.1093/icvts/ivaf244/64612843/ivaf244.pdf
- OA Status
- diamond
- References
- 47
- OpenAlex ID
- https://openalex.org/W4415031102
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4415031102Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/icvts/ivaf244Digital Object Identifier
- Title
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Comparative Study of Different Minimally Invasive Aortic Valve Replacement Techniques: A Systematic Review and Network Meta-AnalysisWork title
- Type
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reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-10-09Full publication date if available
- Authors
-
Theresia Feline Husen, Ananda Pipphali Vidya, Samuel Heuts, Adzana Yasadhy Hangga Prasetyo, Adianto Nugroho, Roberto Lorusso, Elham Bidar, Bart Maesen, Peyman Sardari NiaList of authors in order
- Landing page
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https://doi.org/10.1093/icvts/ivaf244Publisher landing page
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https://academic.oup.com/icvts/advance-article-pdf/doi/10.1093/icvts/ivaf244/64612843/ivaf244.pdfDirect link to full text PDF
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YesWhether a free full text is available
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diamondOpen access status per OpenAlex
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https://academic.oup.com/icvts/advance-article-pdf/doi/10.1093/icvts/ivaf244/64612843/ivaf244.pdfDirect OA link when available
- Cited by
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0Total citation count in OpenAlex
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47Number of works referenced by this work
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| abstract_inverted_index.Abstract | 0 |
| abstract_inverted_index.However, | 272 |
| abstract_inverted_index.Library, | 53 |
| abstract_inverted_index.Medline, | 46 |
| abstract_inverted_index.Scholar, | 55 |
| abstract_inverted_index.Science, | 49 |
| abstract_inverted_index.[0.31]). | 136 |
| abstract_inverted_index.although | 264 |
| abstract_inverted_index.benefits | 32 |
| abstract_inverted_index.bleeding | 259 |
| abstract_inverted_index.caution, | 285 |
| abstract_inverted_index.clinical | 37 |
| abstract_inverted_index.compared | 214, 261 |
| abstract_inverted_index.disease, | 28 |
| abstract_inverted_index.employed | 75 |
| abstract_inverted_index.findings | 280 |
| abstract_inverted_index.hospital | 185, 252 |
| abstract_inverted_index.included | 275 |
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| abstract_inverted_index.invasive | 9 |
| abstract_inverted_index.outcomes | 82, 220 |
| abstract_inverted_index.p-scores | 97 |
| abstract_inverted_index.shortest | 160 |
| abstract_inverted_index.surgical | 23 |
| abstract_inverted_index.−11.10 | 241 |
| abstract_inverted_index.−16.00 | 178 |
| abstract_inverted_index.−26.62 | 181 |
| abstract_inverted_index.(p-score: | 128, 168 |
| abstract_inverted_index.Mortality | 122 |
| abstract_inverted_index.ProQuest. | 57 |
| abstract_inverted_index.Treatment | 85 |
| abstract_inverted_index.appraised | 60 |
| abstract_inverted_index.certainty | 100 |
| abstract_inverted_index.competing | 104 |
| abstract_inverted_index.conducted | 44 |
| abstract_inverted_index.different | 7 |
| abstract_inverted_index.included. | 121 |
| abstract_inverted_index.including | 197, 289 |
| abstract_inverted_index.intensive | 161 |
| abstract_inverted_index.minimally | 8 |
| abstract_inverted_index.operative | 226, 270 |
| abstract_inverted_index.p-scores, | 90 |
| abstract_inverted_index.patients) | 119 |
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| abstract_inverted_index.approaches | 20 |
| abstract_inverted_index.associated | 267 |
| abstract_inverted_index.difference | 143 |
| abstract_inverted_index.mortality. | 110 |
| abstract_inverted_index.randomized | 291 |
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| abstract_inverted_index.reflective | 78 |
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| abstract_inverted_index.systematic | 41 |
| abstract_inverted_index.techniques | 127 |
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| abstract_inverted_index.−0.37]), | 193 |
| abstract_inverted_index.−0.67]). | 243 |
| abstract_inverted_index.−5.38]), | 183 |
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| abstract_inverted_index.5.81-54.80]) | 156 |
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| abstract_inverted_index.thoracoscopic | 18 |
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| abstract_inverted_index.Newcastle-Ottawa | 63 |
| abstract_inverted_index.decision-making. | 38 |
| abstract_inverted_index.mini-thoracotomy | 14 |
| cited_by_percentile_year | |
| countries_distinct_count | 2 |
| institutions_distinct_count | 9 |
| citation_normalized_percentile.value | 0.66256431 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |