Effectiveness and safety of perventricular device closure in congenital perimembranous ventricular septal defects: A systematic review and meta-analysis
10.7507/1007-4848.201811044
- VernacularTitle:先天性膜周型室间隔缺损经胸封堵有效性及安全性的系统评价与 Meta 分析
- Author:
LI Mengsi
1
;
LI Dongxu
2
;
YIN Xiaorong
1
;
AN Qi
2
Author Information
1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China
2. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China
- Publication Type:Journal Article
- Keywords:
Ventricular septal defect;
perimembranous;
perventricular device closure;
complications;
meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(3):251-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and effectiveness of perventricular device closure (PDC) for congenital ventricular septal defects (VSD) by a meta-analysis. Methods PubMed, The Cochrane Library, EMbase and China Biology Medicine (CBM) databases were searched for studies on PDC of VSD up to October 2018 by computer. We included studies only with more than 80% patients diagnosed with perimembranous VSD. A meta-analysis was performed to obtain pooled estimates of success rate and incidences of complications with 95% confidence interval (CI). Subgroup analysis stratified by percentage of perimembranous VSD was performed. Risk difference (RD) was used in the comparison of perioperative data with follow-up data. Results Fifteen studies (2 randomized controlled trials, 3 retrospective cohorts, and other 10 retrospective single-arm studies) involving 4 164 patients (3 848 patients with perimembranous VSD) were included in this meta-analysis. The pooled success rate was 95.4%. Incidences of residual shunt, aortic insufficiency, tricuspid insufficiency, and third-degree atrioventricular block were 5%, 0.1%, 3%, and less than 0.001% respectively. Improvements of residual shunt and aortic insufficiency were confirmed in follow-up patients. Conclusion PDC of congenital perimembranous VSDs is safe and yields good results. Because some limitations can not be overcomed, multicenter randomized controlled trials are needed to confirm our results.
