The efficacy and safety of hybrid arch debranching and open total arch replacement for aortic arch reconstruction: a meta-analysis

Abstract

Abstract Background The present meta-analysis was to explore the long-term prognostic differences between traditional open total arch replacement (OTAR) and hybrid arch repair (HAR) for aortic arch-related pathological disease. Methods We searched the PubMed, Medline, and Embase databases for studies published during the period from January 2009 to January 2019. Survival information was extracted from the Kaplan-Meier curve included in the study with Engauge Digitizer software. A meta-analysis was performed to compare early postoperative mortality, overall survival, and postoperative complications between groups. Results A total of 13 studies with 2080 patients in OTAR and 725 patients in HAR were included in the meta-analysis. The survival rates after HAR were similar to that after OTAR. There was no significant difference between the OTAR and HAR groups in the occurrence of early complications. The results of the sensitivity analysis revealed more acute renal dysfunction but less risk for post-operative stroke in the OTAR cohort compared to the HAR cohort. Conclusion There were no significant differences between OTAR and HAR in terms of overall survival, early mortality, or postoperative spinal cord injury. Both procedures are safe and effective treatments for the treatment of disease affecting the aortic arch.