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经导管室间隔缺损封堵术的最新进展:文献系统评价和荟萃分析。

Recent achievements in transcatheter closure of ventricular septal defects: a systematic review of literature and a meta-analysis.

机构信息

Department of Pediatric Cardiology, Polish‑American Institute of Pediatrics, Jagiellonian University, Medical College, Kraków, Poland

出版信息

Kardiol Pol. 2021 Feb 25;79(2):161-169. doi: 10.33963/KP.15708. Epub 2020 Dec 11.

Abstract

BACKGROUND

Ventricular septal defect (VSD) is one of the most common congenital heart defects. Currently, surgery remains the treatment of choice. However, transcatheter techniques for closing of various types of VSDs have become an alternative.

AIMS

The objective of our study was to present the outcomes of transcatheter closure of various types of VSD based on a systematic review of recent publications.

METHODS

A systematic review of studies published in English between January 2014 and March 2020 was performed using the PubMed database (MEDLINE) independently by 2 reviewers. Data on success and complication rates were extracted. Studies including fewer than 5 patients and those with acquired VSD were excluded from the analysis.

RESULTS

Finally, 44 studies were included for analysis, with a total number of 4050 patients. The pooled estimate of the overall success rate based on the random effects model was 97.96% (95% CI, 97.37-98.56; Q test P 0.99; I 2 = 0%) for permanent VSD.

CONCLUSIONS

Transcatheter closure of selected VSDs appears to be an effective and safe method of treatment. Recent studies have shown high rates of successful interventions with a low incidence of complications.

摘要

背景

室间隔缺损(VSD)是最常见的先天性心脏病之一。目前,手术仍然是首选治疗方法。然而,各种类型的 VSD 的经导管技术已成为一种替代方法。

目的

我们的研究目的是根据最近出版物的系统评价,介绍各种类型的 VSD 的经导管闭合的结果。

方法

我们独立使用 PubMed 数据库(MEDLINE)对 2014 年 1 月至 2020 年 3 月期间发表的英文研究进行了系统评价。提取成功率和并发症发生率的数据。分析排除了少于 5 例患者和获得性 VSD 的研究。

结果

最后,纳入了 44 项研究进行分析,共有 4050 例患者。基于随机效应模型的总体成功率的合并估计值为 97.96%(95%CI,97.37-98.56;Q 检验 P>0.99;I 2 = 0%),用于永久性 VSD。

结论

经导管闭合选定的 VSD 似乎是一种有效且安全的治疗方法。最近的研究表明,介入成功率较高,并发症发生率较低。

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