Effects of transthoracic device closure on ventricular septal defects and reasons for conversion to open-heart surgery: A meta-analysis
| Autor: | Yang Zhou, Hua-Li Peng, Yun-Han Jiang, Shi-Hai Tang, Ling-Xi Liu, Fei Zhao |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Heart Septal Defects
Ventricular Reoperation medicine.medical_specialty Septal Occluder Device lcsh:Medicine 030204 cardiovascular system & hematology Cochrane Library Lower risk Article law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine Randomized controlled trial law medicine Humans Cardiac Surgical Procedures lcsh:Science Heart septal defect Multidisciplinary business.industry lcsh:R Length of Stay medicine.disease Conversion to Open Surgery Surgery Treatment Outcome 030228 respiratory system Echocardiography Meta-analysis Relative risk lcsh:Q business Cohort study |
| Zdroj: | Scientific Reports Scientific Reports, Vol 7, Iss 1, Pp 1-18 (2017) |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-017-12500-6 |
| Popis: | Transthoracic device closure (TTDC) is thought to be a promising technology for the repair of ventricular septal defects (VSDs). However, there is considerable controversy regarding the efficacy and safety of TTDC. The present study aimed to compare the benefits and safety of TTDC with those of conventional open-heart surgery (COHS) and analyze the associated factors causing complications, conversion to COHS and reoperation. Electronic database searches were conducted in PubMed, EMBASE, Cochrane Library, Clinicaltrials.gov and several Chinese databases. A total of 5 randomized controlled trials (RCTs), 7 cohort studies, 13 case-control studies, 129 case series and 13 case reports were included. Compared to COHS, TTDC exhibited superior efficacy with a significantly lower risk of post-operative arrhythmia; however, no significant differences in other outcomes were identified. Meta-regression analysis showed that perimembranous VSDs (pmVSDs), a smaller VSD, a smaller occluder, and a median or subxiphoid approach lowered the relative risk of several post-operative complications, conversion to COHS and reoperation. The current evidence indicates that TTDC is associated with a lower risk of post-operative arrhythmia and is not associated with an increased risk of complications. PmVSDs, a smaller VSD and occluder, and a median or subxiphoid approach correlate with better outcomes when using TTDC. |
| Databáze: | OpenAIRE |
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