Comparative mortality outcomes of linear versus patch ventriculoplasty in patients with ventricular aneurysm: a meta-analysis

OBJECTIVE: In the surgical management of ventricular aneurysms, most surgeons that patch ventriculoplasty achieves superior clinical outcomes compared with linear ventriculoplasty. However, despite numerous comparative studies, small sample sizes and methodological limitations have prevented definitive conclusions. Therefore, this systematic review and meta-analysis aimed to quantitatively synthesize and evaluate the existing evidence. METHODS: A comprehensive literature search was conducted across Embase, Ovid Medline, and Web of Science to identify studies comparing linear and patch ventriculoplasty. Short-term mortality and long-term mortality were analyzed and compared between the two techniques. Data synthesis was performed using fixed- or random-effects models based on the I² statistic. The certainty of evidence was graded by using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: After rigorous screening, 28 studies encompassing 3,032 patients were included. None were randomized controlled trials, and only one was prospective. Short-term mortality did not differ significantly between linear and patch ventriculoplasty (risk ratio: 1.11, 95% CI: 0.82-1.51, P = 0.49, I2 = 0.00%), with very low certainty of evidence. In contrast, long-term mortality was significantly higher after linear ventriculoplasty (rate ratio: 1.24, 95% CI: 1.03-1.49, P = 0.03, I2 = 12.40%), also with very low certainty of evidence. CONCLUSION: Compared with linear ventriculoplasty, patch ventriculoplasty yields similar short-term mortality but may confer a significantly lower long-term mortality.