经皮心室装置封堵术与外科手术修复孤立性先天性室间隔缺损的中期结果比较：一项系统评价和荟萃分析

Midterm Results Comparing Perventricular Device Closure with Surgical Repair for Isolated Congenital Ventricular Septal Defects: A Systematic Review and Meta-Analysis.

作者信息

Yu Juemin, Liufu Rong, Wang Ximeng, Liu Xiaobing, Zhuang Jian

机构信息

School of Medicine, South China University of Technology, 510641 Guangzhou, Guangdong, China.

Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510260 Guangzhou, Guangdong, China.

出版信息

Rev Cardiovasc Med. 2022 Jul 20;23(8):262. doi: 10.31083/j.rcm2308262. eCollection 2022 Aug.

DOI:10.31083/j.rcm2308262

PMID:39076627

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11266945/

Abstract

BACKGROUND

This systematic review and meta-analysis aimed at comparing the midterm outcomes of perventricular device closure (PDC) with conventional surgical repair (CSR) for VSD.

METHODS

PubMed, Cochrane Library, and Web of Science databases were searched from January 1, 2005, to October 15, 2020, for English or Chinese language studies comparing outcomes of PDC with CSR for VSD. The midterm results were assessed as a primary outcome. A systematic review and meta-analysis was performed under the frequentist frame with risk ratio (RR) and 95% confidence interval (CI).

RESULTS

A total of 4381 patients (PDC = 2016, CSR = 2365) from 15 studies were included. The pooled estimates of success rate favored the CSR compared with the PDC (RR, 0.97; 95% CI, 0.96 to 0.99; = 0.001). No significant differences in minor complications or severe complications were found between the PDC and CSR (RR, 0.79; 95% CI, 0.50 to 1.23; = 0.29; RR, 1.43; 95% CI, 0.74 to 2.75; = 0.29). The pooled estimates of residual shunts favored the PDC compared with the CSR (RR, 9.07; 95% CI, 4.77 to 17.24; 0.001), the pooled estimates of aortic regurgitation favored the CSR compared with the PDC (RR, 1.59; 95% CI, 1.05 to 2.39; = 0.03).

CONCLUSIONS

PDC is a safe and effective procedure with less surgical injury and shorter perioperative hospital stay. However, aortic regurgitation is a concern during follow-up.

摘要

背景

本系统评价和荟萃分析旨在比较室间隔缺损（VSD）的心室周装置闭合术（PDC）与传统外科修复术（CSR）的中期结果。

方法

检索2005年1月1日至2020年10月15日期间的PubMed、Cochrane图书馆和Web of Science数据库，查找比较PDC与CSR治疗VSD结果的英文或中文研究。将中期结果作为主要结局进行评估。在频率学派框架下，采用风险比（RR）和95%置信区间（CI）进行系统评价和荟萃分析。

结果

纳入了15项研究中的4381例患者（PDC组 = 2016例，CSR组 = 2365例）。与PDC相比，CSR的成功率合并估计值更优（RR，0.97；95%CI，0.96至0.99；P = 0.001）。PDC与CSR在轻微并发症或严重并发症方面未发现显著差异（RR，0.79；95%CI，0.50至1.23；P = 0.29；RR，1.43；95%CI，0.74至2.75；P = 0.29）。与CSR相比，PDC的残余分流合并估计值更优（RR，9.07；95%CI，4.77至17.24；P < 0.001），与PDC相比，CSR的主动脉反流合并估计值更优（RR，1.59；95%CI，1.05至2.39；P = 0.03）。