%0 Journal Article
%T Systematic review and meta-analysis of surgical outcomes comparing mechanical valve replacement and bioprosthetic valve replacement in infective endocarditis
%A Flynn, Campbell D.
%A Curran, Neil P.
%A Chan, Stephanie
%A Zegri-Reiriz, Isabel
%A Tauron, Manel
%A Tian, David H.
%A Pettersson, Gosta B.
%A Coselli, Joseph S.
%A Misfeld, Martin
%A Antunes, Manuel J.
%A Mestres, Carlos A.
%A Quintana, Eduard
%J Annals of Cardiothoracic Surgery
%D 2019
%B 2019
%9 
%! Systematic review and meta-analysis of surgical outcomes comparing mechanical valve replacement and bioprosthetic valve replacement in infective endocarditis
%K 
%X Background: Infective endocarditis (IE) is an infection involving either native or prosthetic heart valves, the endocardial surface of the heart or any implanted intracardiac devices. IE is a rare condition affecting 3–15 patients per 100,000 population. In-hospital mortality rates in patients with IE remain high at around 20% despite treatment advances. There is no consensus recommendation favoring either bioprosthetic valve or mechanical valve implantation in the setting of IE; patient age, co-morbidities and preferences should be considered selecting the replacement prosthesis.  Methods: A systematic review and meta-analysis of studies reporting the outcomes of patients undergoing bioprosthetic or mechanical valve replacement for infective endocarditis with data extracted for overall survival, valve reinfection rates and valve reoperation.  Results: Eleven relevant studies were identified, with 2,336 patients receiving a mechanical valve replacement and 2,057 patients receiving a bioprosthetic valve replacement. There was no significant difference for overall survival between patients treated with mechanical valves and those treated with bioprosthetic valves [hazard ratio (HR) 0.94, 95% confidence interval (CI): 0.73–1.21, P=0.62]. There was no significant difference in reoperation rates between patients treated with a bioprosthetic valve and those treated with a mechanical valve (HR 0.82, 95% CI: 0.34–1.98, P=0.66) and there was no significant difference in the rate of valve reinfection rates (HR 0.95, 95% CI: 0.48–1.89, P=0.89).  Conclusions: The presence of infective endocarditis alone should not influence the decision of which type of valve prosthesis that should be implanted. This decision should be based on patient age, co-morbidities and preferences.
%U https://www.annalscts.com/article/view/16668
%V 8
%N 6
%P 587-599
%@ 2304-1021