Loomba Rohit S, Flores Saul, Villarreal Enrique G, Bronicki Ronald A, Anderson Robert H
Cardiology, Pediatrics, Advocate Children's Hospital, Oak Lawn, IL, USA.
Critical Care and Cardiology, Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
World J Pediatr Congenit Heart Surg. 2019 Sep;10(5):616-623. doi: 10.1177/2150135119859882.
We performed a meta-analysis of studies to determine whether the modified single-patch technique offers benefits when compared to the two-patch repair. The postoperative outcomes examined in this study were cardiopulmonary bypass time, cross-clamp time, duration of mechanical ventilation, intensive care unit length of stay, total hospital length of stay, need for reoperation, need for reoperation for left ventricular outflow tract obstruction or left atrioventricular valve regurgitation, need for pacemaker implantation, and mortality during follow-up.
A review was conducted to identify studies comparing a modified single-patch repair versus two-patch repair. A fixed-effects model was utilized for end points with low heterogeneity and a random-effects model for end points with significant heterogeneity. Meta-regression was also performed to determine the influence of other factors on the variables of interest.
A total of 964 unique manuscripts were screened, with 10 being included in the final analyses. There were a total of 724 patients, with 353 (49%) having undergone repair utilizing a modified single-patch repair. Mean age at repair for modified single-patch repair and two-patch repair was 8.81 and 9.03 months, respectively. Significant differences were noted in cardiopulmonary bypass time and cross-clamp time with mean difference of -28.53 and -22.69 minutes, respectively. In comparison to the two-patch repair, both times were decreased in modified single-patch repair. No significant difference was noted in any other variables.
Modified single-patch repair for atrioventricular septal defects requires less cardiopulmonary bypass and cross-clamp time but does not significantly impact the examined postoperative outcomes.
我们对多项研究进行了荟萃分析，以确定与双补片修复相比，改良单补片技术是否具有优势。本研究中所检查的术后结果包括体外循环时间、主动脉阻断时间、机械通气时间、重症监护病房住院时间、总住院时间、再次手术需求、因左心室流出道梗阻或左房室瓣反流而再次手术的需求、起搏器植入需求以及随访期间的死亡率。
进行一项综述以识别比较改良单补片修复与双补片修复的研究。对于异质性较低的终点采用固定效应模型，对于具有显著异质性的终点采用随机效应模型。还进行了荟萃回归以确定其他因素对感兴趣变量的影响。
共筛选了964篇独特的手稿，最终分析纳入了10篇。共有724例患者，其中353例（49%）接受了改良单补片修复。改良单补片修复和双补片修复的平均修复年龄分别为8.81个月和9.03个月。体外循环时间和主动脉阻断时间存在显著差异，平均差异分别为-28.53分钟和-22.69分钟。与双补片修复相比，改良单补片修复的这两个时间均缩短。在任何其他变量中均未发现显著差异。
房室间隔缺损的改良单补片修复需要的体外循环和主动脉阻断时间更少，但对所检查的术后结果没有显著影响。
