Ductus Arteriosus Stent Compared with Surgical Shunt for Infants with Ductal-Dependent Pulmonary Blood Flow: A Systematic Review and Meta-Analysis

查看全文 作　　者：Sibao [1]Wang;Silin [1]Pan;Gang [1]Luo;Zhixian [1]Ji;Na [1]Liu 机构地区：[1]Heart Center,Qingdao Women and Children’s Hospital,Qingdao University,Qingdao,266034,China 出　　处：《Congenital Heart Disease》索引2022年第17卷第1期,共16页 摘　　要：The aim of this study was to perform a systematic review and meta-analysis to evaluate the safety and efficacy of ductus arteriosus stent(DAS)compared with surgical systemic-pulmonary artery shunt(SPS)in patients with ductal-dependent pulmonary blood flow.A literature search was conducted in PubMed,Embase,and the Cochrane Library databases from their inception to December 2020.Two reviewers independently screened the articles,evaluated the quality of the articles,and collected the data.Meta-analyses were conducted using fixed and random effects models.We used the I-square(I2)test to examine heterogeneity and the funnel plot Egger’s test was used to test for publication bias.We analyzed nine studies including 842 patients were included in the present study(DAS:n=295;SPS:n=547).There was a benefit in favor of DAS group for medium-term mortality(RR,0.63;95%CI,[0.40,0.99];P=0.91,I^(2)=0%).DAS group demonstrated a reduced risk for complications compared with SPS(RR,0.46;95%CI,[0.29,0.72];P=0.78,I^(2)=0%).There was an increased risk for unplanned reintervention for DAS(RR,1.77;95%CI,[1.42,2.20];P=0.61,I2=0%).DAS demonstrated shorter mean intensive care unit length of stay(MD,–5.12;95%CI,[–7.33,–2.91];P=0.005,I^(2)=76%).There was also demonstrated higher postprocedure oxygen saturation for SPS over DAS(MD,1.78;95% CI,[0.92,2.64];P=0.46,I2=0%).There was no difference between the two groups in terms of mortality within 30 days,Nakata Index,and hospital length of stay.Conclusions:In terms of initial palliative surgical in the ductal-dependent pulmonary blood flow,DAS demonstrated a lower risk of medium-term mortality,lower risk of complications,higher risk of unplanned reintervention,shorter ICU length of stay,and higher postprocedure oxygen saturation compared with SPS. 关 键 词：Surgical shunt Blalock-Taussig shunt ductus arteriosus STENTS INFANTS META-ANALYSIS