TY - JOUR AU - Flynn, Campbell D. AU - Curran, Neil P. AU - Chan, Stephanie AU - Zegri-Reiriz, Isabel AU - Tauron, Manel AU - Tian, David H. AU - Pettersson, Gosta B. AU - Coselli, Joseph S. AU - Misfeld, Martin AU - Antunes, Manuel J. AU - Mestres, Carlos A. AU - Quintana, Eduard PY - 2019 TI - Systematic review and meta-analysis of surgical outcomes comparing mechanical valve replacement and bioprosthetic valve replacement in infective endocarditis JF - Annals of Cardiothoracic Surgery; Vol 8, No 6 (November 29, 2019): Endocarditis Y2 - 2019 KW - N2 - 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. UR - https://www.annalscts.com/article/view/16668