■本系统综述和荟萃分析旨在比较室间隔缺损的室间隔缺损封堵(PDC)与常规手术修复(CSR)的中期结果。
■PubMed,科克伦图书馆,从2005年1月1日至2020年10月15日,搜索了WebofScience数据库,以比较VSD的PDC和CSR结果的英语或中文研究。中期结果被评估为主要结果。在风险比(RR)和95%置信区间(CI)的频率范围内进行系统评价和荟萃分析。
■共纳入15项研究的4381名患者(PDC=2016,CSR=2365)。与PDC相比,成功率的汇总估计有利于企业社会责任(RR,0.97;95%CI,0.96至0.99;p=0.001)。在PDC和CSR之间没有发现轻微并发症或严重并发症的显着差异(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(RR,9.07;95%CI,4.77至17.24;p<0.001),与PDC相比,主动脉瓣返流的汇总估计有利于CSR(RR,1.59;95%CI,1.05至2.39;p=0.03)。
■PDC是一种安全有效的手术方法,手术损伤较小,围手术期住院时间较短。然而,主动脉瓣反流是随访期间的一个问题.
UNASSIGNED: This systematic review and meta-analysis aimed at comparing the midterm outcomes of perventricular device closure (PDC) with conventional surgical repair (CSR) for VSD.
UNASSIGNED: 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).
UNASSIGNED: 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; p = 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; p = 0.29; RR, 1.43; 95% CI, 0.74 to 2.75; p = 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; p < 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; p = 0.03).
UNASSIGNED: 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.