Efficacy of echocardiography-guided alone versus fluoroscopy-guided percutaneous closure of atrial septal defect: A systematic review and meta-analysis
- VernacularTitle:单纯超声心动图引导与放射线引导经皮封堵房间隔缺损疗效比较的系统评价与Meta分析
- Author:
Wenxin WANG
1
;
Xin DONG
2
;
Xin ZHANG
1
;
Jianguo XU
3
;
Xiaolong HE
1
;
Chengfei LIU
4
;
Kang YI
5
;
Tao YOU
5
Author Information
1. 1. The First Clinical Medical School of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China 2. Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease, Lanzhou, 730000, P. R. China
2. epartment of Ultrasound Medicine, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China
3. Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, P. R. China
4. 2. Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease, Lanzhou, 730000, P. R. China 5. The First Clinical Medical School of Lanzhou University, 730000, P. R. China
5. 2. Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease, Lanzhou, 730000, P. R. China 6. Department of Cardiovascular Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China
- Publication Type:Journal Article
- Keywords:
Atrial septal defect;
percutaneous closure;
echocardiography;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(10):1490-1498
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the safety and efficacy of percutaneous closure of atrial septal defect (ASD) guided by echocardiography alone versus fluoroscopy. Methods The databases of PubMed, The Cochrane Library, EMbase, VIP, Wanfang Data and CNKI from January 2000 to October 2021 were searched by computer for relevant research literature. Two reviewers independently screened the literature, extracted the data and evaluated the quality according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. Results A total of 19 cohort studies and 1 randomized controlled study were collected, including 2 825 patients. The Newcastle-Ottawa Scale score for cohort studies was≥7 points. Meta-analysis showed that there was no statistical difference in the operative success rate (RR=1.01, 95%CI 1.00 to 1.02, P=0.17), incidence of occluder displacement/shedding (RR=0.77, 95%CI 0.26 to 2.27, P=0.63), incidence of arrhythmia (RR=0.50, 95%CI 0.21 to 1.14, P=0.10), incidence of pericardial effusion (RR=0.98, 95%CI 0.32 to 2.98, P=0.97), operative time (MD=–0.23, 95%CI –7.56 to 7.10, P=0.95) or cost (SMD=–0.39, 95%CI –1.09 to 0.30, P=0.27) between the two groups. The echocardiography group reduced the incidence of total postoperative complications (RR=0.42, 95%CI 0.30 to 0.60, P<0.001) and residual shunt (RR=0.70, 95%CI 0.50 to 0.98, P=0.04), and shortened length of hospital stay (MD=–0.43, 95%CI –0.77 to 0.09, P=0.01). Conclusion Compared with traditional fluoroscopy-guided percutaneous closure of ASD, echocardiography guidance alone is equivalent in terms of operative success rate, major postoperative complications, operative time and total cost, but it reduces the incidence of total postoperative complications and residual shunt, and has a shorter length of hospital stay.
