{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T00:47:35Z","timestamp":1794271655254,"version":"4.9.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p\/>\n               <jats:p>The long-term results in studies comparing octogenarian patients who received either isolated surgical aortic valve replacement (i-SAVR) or coronary artery bypass grafting (CABG) in addition to SAVR are still debated. We performed a reconstructed time-to-event data meta-analysis of studies comparing i-SAVR and CABG+SAVR to evaluate the impact of CABG and to analyse the time-varying effects on long-term outcome. We performed a systematic review of the literature from January 2000 through November 2021, including studies comparing i-SAVR and CABG+SAVR, which reported at least 3-year follow-up and that plotted Kaplan\u2013Meier curves of overall survival. The primary endpoint was overall long-term survival; secondary endpoints were in-hospital\/30-day mortality and postoperative outcomes. The pooled hazard ratio (HR) and odds ratio) with 95% confidence interval (CI) were calculated for primary and secondary endpoints, respectively. Random-effect model was used in all analyses. Sixteen retrospective studies were included (5382 patients, i-SAVR\u2009=\u20092568 and CABG+SAVR\u2009=\u20092814). I-SAVR showed a lower incidence of in-hospital mortality compared to CABG+SAVR (odds ratio\u2009=\u20090.73; 95% CI= 0.60\u20130.89; P\u2009=\u20090.002). Landmark analyses showed a significantly higher all-cause mortality within 1 year from surgery in CABG+SAVR (HR\u2009=\u20091.17; 95% CI\u2009=\u20091.01\u20131.36; P\u2009=\u20090.03); after 1 year, no significant difference was observed (HR\u2009=\u20090.95; 95% CI\u2009=\u20090.87\u20131.04; P\u2009=\u20090.35). Landmark analysis was confirmed by time-varying trend of HR. Late survival of octogenarians did not differ significantly between the 2 interventions. Interestingly, CABG added to SAVR was associated with both higher in-hospital and within 1-year mortality after surgery, whereas this difference was statistically non-significant at long-term follow-up.<\/jats:p>","DOI":"10.1093\/icvts\/ivac164","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T13:42:55Z","timestamp":1655732575000},"source":"Crossref","is-referenced-by-count":16,"title":["The impact of coronary artery bypass grafting added to aortic valve replacement on long-term outcomes in octogenarian patients: a reconstructed time-to-event meta-analysis"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5079-9330","authenticated-orcid":false,"given":"Alan","family":"Gallingani","sequence":"first","affiliation":[{"name":"Cardiac Surgery Unit, Parma University Hospital , Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"D\u2019Alessandro","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, San Gerardo Hospital , Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurmeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and Division of Cardiac Surgery, Mazankowski, Alberta Heart Institute, University of Alberta , Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3518-6629","authenticated-orcid":false,"given":"Daniel","family":"Hernandez-Vaquero","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario Central de Asturias , Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mevl\u00fct","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Erasmus University Medical Center , Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelina","family":"Ceccato","sequence":"additional","affiliation":[{"name":"Medical Library, University of Parma , Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2174-9240","authenticated-orcid":false,"given":"Francesco","family":"Nicolini","sequence":"additional","affiliation":[{"name":"Medical Library, University of Parma , Parma, Italy"},{"name":"Department of Medicine and Surgery, University of Parma , Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3989-6134","authenticated-orcid":false,"given":"Francesco","family":"Formica","sequence":"additional","affiliation":[{"name":"Medical Library, University of Parma , Parma, Italy"},{"name":"Department of Medicine and Surgery, University of Parma , Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"2022071107565816300_ivac164-B1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/ejcts\/ezab389","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"60","author":"Vahanian","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022071107565816300_ivac164-B2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.athoracsur.2003.12.060","article-title":"Outcome after aortic valve replacement in octogenarians","volume":"78","author":"Chiappini","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"2022071107565816300_ivac164-B3","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1093\/ejcts\/ezr029","article-title":"Aortic valve replacement with and without combined coronary bypass grafts in very elderly patients: early and long-term 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