A comparison of the results of the bicaval and biatrial surgical technique in orthotopic heart transplantation: A review and meta-analysis

Amaç: Bu çalışmada ortotopik kalp naklinde bikaval ve biatriyal tekniklerin sonuçları değerlendirildi. Çalışma planı: Mayıs 1966 ve Mayıs 2011 tarihleri arasında, PubMed, Medline ve Google gibi elektronik arama motorları ve kalp ve damar cerrahisiyle ilgili dergiler manuel olarak incelenerek, literatür taraması yapıldı. Kapsama kriterlerine uyan toplam 36 prospektif ve retrospektif kontrollü çalışma meta-analize dahil edildi. Her iki tekniğin sonuçları, anlamlı heterojenite olup olmamasına göre, rastgele ve sabit etki yöntemi kullanılarak değerlendirildi. İstatistik değerlendirme Comprehensive Meta Analysis version 2 yazılımı kullanılarak yapıldı. Bulgular: Elde edilen sekiz meta-analiz sonucunun (triküspit ve mitral yetmezlik, kalıcı veya geçici pacemaker gereksinimi, sinüs ritmi, 1 ve 10 yıllık sağkalım, sağ atriyal basınç) anlamlı olarak bikaval grupta, biatriyal gruba göre daha iyi olduğu bulundu. Sonuç: Çalışma bulguları, biatriyal tekniğe kıyasla, bikaval tekniğin sonuçlarının daha iyi olduğunu göstermektedir. Bikaval anastomoz tekniğinin sağladığı klinik ve hemodinamik yararlar göz önünde bulundurulduğunda, morbiditeyi olumlu yönde etkileyebileceğini düşünmekteyiz.

Ortotopik kalp naklinde bikaval ve biatriyal cerahi teknik sonuçlarının karşılaştırılması: Derleme ve meta-analiz

Background: This study aims to evaluate the outcomes of bicaval and biatrial techniques in orthotopic heart transplantation. Methods: Between May 1966 and May 2011, a literature survey was conducted using electronic search engines including PubMed, Medline and Google and manually surveying the magazines on heart and vascular surgery. A total of 36 prospective and retrospective controlled studies which met the inclusion criteria were included in the metaanalysis. The outcomes of both techniques were evaluated using random and fixed-effect method, based on their significant heterogeneous nature. Statistical analysis was performed using Comprehensive Meta Analysis version 2 software. Results: It was found that the results of eight meta-analyses obtained (tricuspid and mitral insufficiency, the need for permanent or temporary pacemaker, sinus rhythm, survival at 1 and 10 year, the right atrial pressure) were significantly improved in bicaval group, compared to the biatrial group. Conclusion: Our study results showed that the outcomes of the bicaval technique were better, compared to biatrial technique. We believe that the bicaval anastomosis technique may have a positive effect on morbidity, due to its clinical and hemodynamical benefits.

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