Cochrane · systematic review · CD011793
Limited versus full sternotomy for aortic valve replacement
Kirmani, BH, Jones, SG, Muir, A, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 28.6%Low 4 · 57.1%Moderate 1 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlySummary of findings table ‐ Limited sternotomy compared to full sternotomy for aortic valve replacement
Population: adults undergoing aortic valve replacement
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Summary of findings table ‐ Limited sternotomy vs full sternotomy | RR 0.93 [0.45, 1.94] | 10 studies · 985 participants | Low Downgraded: risk of bias, imprecision |
Cardiopulmonary bypass time (minutes) Summary of findings table ‐ Limited sternotomy vs full sternotomy | no estimate extracted | 10 studies · 1043 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Aortic cross‐clamp time (minutes) Summary of findings table ‐ Limited sternotomy vs full sternotomy | no estimate extracted | 12 studies · 1235 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Postoperative blood loss (mL) Summary of findings table ‐ Limited sternotomy vs full sternotomy | no estimate extracted | 8 studies · 767 participants | Moderate Downgraded: inconsistency |
Pain scores, measured in various ways at a median of 2 days' Summary of findings table ‐ Limited sternotomy vs full sternotomy | no estimate extracted | 5 studies · 649 participants | Low Downgraded: risk of bias, inconsistency |
Quality of life, Summary of findings table ‐ Limited sternotomy vs full sternotomy | no estimate extracted | 4 studies · 624 participants | Low Downgraded: risk of bias, imprecision |
Index admission costs Summary of findings table ‐ Limited sternotomy vs full sternotomy | no estimate extracted | 2 studies · 492 participants | Low Downgraded: imprecision, indirectness |
Limited upper hemi‐sternotomy versus full median sternotomy for aortic valve replacement
Population: participants requiring aortic valve replacement
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Limited upper hemi‐sternotomy vs full median sternotomy | RR 1.01 [0.36, 2.82] | 7 studies · 511 participants | Moderate Downgraded: imprecision |
Cardiopulmonary bypass time Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 5 studies · 311 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Aortic cross‐clamp time Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 6 studies · 391 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Length of hospital stay Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 5 studies · 297 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Postoperative blood loss Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 5 studies · 297 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Deep sternal wound infection Limited upper hemi‐sternotomy vs full median sternotomy | RR 0.71 [0.22, 2.3] | 7 studies · 511 participants | Moderate Downgraded: imprecision |
Pain scores Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 3 studies · 197 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Intensive care unit length of stay Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 5 studies · 297 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Postoperative pulmonary function tests Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 4 studies · 257 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Re‐exploration Limited upper hemi‐sternotomy vs full median sternotomy | RR 1.01 [0.48, 2.13] | 7 studies · 511 participants | Moderate Downgraded: imprecision |
Postoperative atrial fibrillation Limited upper hemi‐sternotomy vs full median sternotomy | RR 0.6 [0.07, 4.89] | 3 studies · 240 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Postoperative ventilation time Limited upper hemi‐sternotomy vs full median sternotomy | no estimate extracted | 6 studies · 297 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |