Bauser-Heaton Holly, Price Katherine, Weber Rachel, El-Said Howaida
Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
Department of Pediatrics, University of California San Diego School of Medicine, San Diego, California.
J Soc Cardiovasc Angiogr Interv. 2022 Jul 7;1(6):100392. doi: 10.1016/j.jscai.2022.100392. eCollection 2022 Nov-Dec.
Patent ductus arteriosus (PDA) stent placement and systemic-pulmonary surgical shunt procedure can both be performed as palliation for infants with duct-dependent pulmonary circulation. The aim of this meta-analysis and literature review was to compare outcomes and study populations between the 2 methods as well as review the technical considerations and complications of PDA stenting.
A systematic search was conducted using the PubMed database and meta-analysis was performed. Risk ratio and mean difference were used to compare the reported outcomes of studies across patients receiving PDA stent and surgical shunt.
In total, 1094 patients from 8 comparative observational studies were included. The PDA stent group had a lower mortality rate and a shorter hospital length of stay than the systemic-pulmonary surgical shunt group, although at the expense of increased reintervention rates. There were higher proportions of patients with single-ventricle physiology and single-source pulmonary blood flow in the surgical shunt group.
PDA stenting appears to be a noninferior or possibly superior method of palliation for duct-dependent pulmonary circulation compared with systemic-pulmonary surgical shunt, recognizing, however, that patients receiving surgical shunt more often had single-ventricle physiology or single-source pulmonary blood flow in this meta-analysis.
动脉导管未闭（PDA）支架置入术和体肺分流手术均可作为依赖动脉导管的肺循环婴儿的姑息治疗方法。本荟萃分析和文献综述的目的是比较这两种方法的治疗效果和研究人群，并回顾PDA支架置入术的技术要点和并发症。
使用PubMed数据库进行系统检索并进行荟萃分析。采用风险比和平均差来比较接受PDA支架置入术和手术分流术患者的研究报告结果。
总共纳入了来自8项比较观察性研究的1094例患者。PDA支架组的死亡率低于体肺分流手术组，住院时间也更短，尽管再次干预率有所增加。手术分流组中具有单心室生理和单源肺血流的患者比例更高。
与体肺分流手术相比，PDA支架置入术似乎是一种不劣于或可能优于依赖动脉导管的肺循环姑息治疗方法，然而，在本荟萃分析中，接受手术分流的患者更常具有单心室生理或单源肺血流。
