COMPARATIVE EFFICACY OF SUBVALVULAR PROCEDURE VERSUS ISOLATED ANNULOPLASTY IN MITRAL VALVE REPAIR: A META- ANALYSIS ON MORTALITY AND MITRAL REGURGITATION RECURRENCE
Bibliographic record
Abstract
Introduction: The aim of this meta-analysis is to identify if adding subvalvular procedure (SVP) in mitral valve repair in functional mitral regurgitation (MR) improves the result in contrast to isolated annuloplasty (AN). Methods: A literature search in PubMed, Cochrane Library, and ClinicalTrials.gov covered January 2010 to August 2024, focusing on ischemic and functional mitral disease, mitral valve repair, and surgical techniques. Inclusion criteria followed PRISMA guidelines with the primary objective to compare early and late mortality and MR recurrence. Screening involved independent assessments with a PRISMA flowchart. Bias was evaluated with ROBINS-E, quality with the modified Newcastle-Ottawa scale, and heterogeneity with I 2 statistics, controlling for high-quality studies only as sensitivity analysis. Results: A total of 1904 papers were found with a traditional research and 164 with the Umbrella research. After screening, 14 studies were included, for a total of 999 patients, of which 519 (51.95%) underwent AN and 480 (48.05%) underwent adjunctive SVP. There was no difference in early mortality (OR 0.91, CI95% 0.46-1.8, p=0.87, I2=0), in late mortality (OR 1.24, CI95% -0.17-0.60, p=0.28, I2=0) nor post operative complications (OR 0.7, CI95% 0.35- 1.39, p=0.3035, I2= 70.63) but in the SVP group there was a significant reduction in MR recurrence with OR 0.48, CI95% 0.33-0.71, p = 0.0002, I2=0. No publication bias was found, even if 9 studies (64.29%) showed high risk of bias with ROBINS-E tool. Conclusions: SVP are associated with lower rates of MR recurrence, without modifying mortality nor immediate post-operative complications.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.032 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.058 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".