Frozen Elephant Trunk Technique in Aortic Arch Surgery
Frozen Elephant Trunk Technique in Aortic Arch Surgery
Electronic searches were performed using Ovid Medline, PubMed, Cochrane Central Register of Controlled Trials (CCTR), Cochrane Database of Systematic Reviews (CDSR), ACP Journal Club, and Database of Abstracts of Review of Effectiveness (DARE) from their date of inception to June 2013. To achieve the maximum sensitivity of the search strategy and identify all studies, we combined the terms: "frozen elephant trunk (FET)" OR "stented elephant trunk" OR "antegrade stenting descending thoracic aorta" as either key words or MeSH terms. The reference lists of all retrieved articles were reviewed for further identification of potentially relevant studies. All identified articles were systematically assessed using the inclusion and exclusion criteria.
Eligible studies for the present systematic review and meta-analysis included those in which patient cohorts underwent surgery for aortic arch and descending arch pathologies, which utilized the FET approach. Studies that did not include predetermined primary or secondary endpoints were excluded. When institutions published duplicate studies with accumulating numbers of patients or increased lengths of follow-up, only the most complete reports were included for quantitative assessment at each time interval. All publications were limited to those involving human subjects and in the English language. Abstracts, case reports, conference presentations, editorials, and expert opinions were excluded. Review articles were omitted because of potential publication bias and duplication of results.
All data were extracted from article texts, tables and figures by one of the investigators (B.W.). Data was subsequently reviewed and tabulated by another investigator (D.H.T.). Discrepancies between the two reviewers were resolved by discussion and consensus. The final results were reviewed by the senior investigator (T.D.Y.). The quality of studies was assessed using criteria recommended by the National Health Service Centre for Reviews and Dissemination case series quality assessment criteria (University of York, Heslington, United Kingdom). Data are presented as mean ± standard deviation. Weighted means are calculated by determining the total number of events divided by total sample size. Weighted Spearman's coefficient (rs) is used to calculate correlation between non-parametric continuous variables using SPSS version 21 (SPSS Inc, Chicago, USA). A significant P value is assumed to be <0.05.
Methods
Literature Search Strategy
Electronic searches were performed using Ovid Medline, PubMed, Cochrane Central Register of Controlled Trials (CCTR), Cochrane Database of Systematic Reviews (CDSR), ACP Journal Club, and Database of Abstracts of Review of Effectiveness (DARE) from their date of inception to June 2013. To achieve the maximum sensitivity of the search strategy and identify all studies, we combined the terms: "frozen elephant trunk (FET)" OR "stented elephant trunk" OR "antegrade stenting descending thoracic aorta" as either key words or MeSH terms. The reference lists of all retrieved articles were reviewed for further identification of potentially relevant studies. All identified articles were systematically assessed using the inclusion and exclusion criteria.
Selection Criteria
Eligible studies for the present systematic review and meta-analysis included those in which patient cohorts underwent surgery for aortic arch and descending arch pathologies, which utilized the FET approach. Studies that did not include predetermined primary or secondary endpoints were excluded. When institutions published duplicate studies with accumulating numbers of patients or increased lengths of follow-up, only the most complete reports were included for quantitative assessment at each time interval. All publications were limited to those involving human subjects and in the English language. Abstracts, case reports, conference presentations, editorials, and expert opinions were excluded. Review articles were omitted because of potential publication bias and duplication of results.
Data Extraction and Critical Appraisal
All data were extracted from article texts, tables and figures by one of the investigators (B.W.). Data was subsequently reviewed and tabulated by another investigator (D.H.T.). Discrepancies between the two reviewers were resolved by discussion and consensus. The final results were reviewed by the senior investigator (T.D.Y.). The quality of studies was assessed using criteria recommended by the National Health Service Centre for Reviews and Dissemination case series quality assessment criteria (University of York, Heslington, United Kingdom). Data are presented as mean ± standard deviation. Weighted means are calculated by determining the total number of events divided by total sample size. Weighted Spearman's coefficient (rs) is used to calculate correlation between non-parametric continuous variables using SPSS version 21 (SPSS Inc, Chicago, USA). A significant P value is assumed to be <0.05.
