Network meta-analysis to compare the efficacies of three surgical techniques in rheumatic mitral valve disease

TL;DR

This study compares three surgical techniques for treating rheumatic mitral valve disease and finds that mitral valvuloplasty has better outcomes than other methods.

Contribution

A network meta-analysis comparing PMBC, MVP, and MVR in rheumatic mitral valve disease, revealing MVP's superior outcomes.

Findings

MVP had lower early mortality, follow-up mortality, and complication rates compared to MVR.

MVP had a significantly lower follow-up reoperation rate than PMBC.

Abstract

This systematic review compared the efficacies of percutaneous mitral balloon commissurotomy (PMBC), mitral valvuloplasty (MVP), and mitral valve replacement (MVR) in patients with rheumatic mitral valve disease. Data from 15,271 patients across 23 cohort studies and randomized controlled trials were analyzed. Based on the results of the network meta-analysis, MVP demonstrated a lower early mortality rate [odds ratio (OR), 0.71; 95% confidence interval (CI): 0.54–0.92], follow-up mortality rate (OR: 0.84; 95% CI: 0.72-0.99), and complication rate (OR: 0.75; 95% CI: 0.64-0.88) compared to MVR. The follow-up reoperation rate in the MVP group was significantly lower than that in the PMBC group (OR: 0.49; 95% CI: 0.30–0.80). The optimal surgical strategy should be tailored to achieve better prognoses.

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