机构:[1]Department of Obsterics Ultrasound, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650034, China云南省第一人民医院[2]Department of Ultrasound Echocardiography, Yanan Hospital of Kunming City, Yunnan Cardiovascular Hospital, Kunming, Yunnan, 650233, China[3]Department of Neurosurgery, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan, Kunming, Yunnan, 650021, China[4]Department of Cardiovascular Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, China外科科室心脏大血管外科(心脏外科)昆明医科大学附属第一医院[5]Department of Cardiovascular Medicine, Sir Run Run Hospital Affiliated Nanjing Medical University, Nanjing, Jiangsu, 211166, China
Objective Postinfarction ventricular septal defect (PIVSD) is a severe complication of acute myocardial infarction (AMI). Transcatheter closure (TCC) is an alternative option to surgical repair. This study was undertaken to examine the published literature to provide objective evidence for TCC using a meta-analysis. Methods We searched for significant medical and publisher databases. Two reviewers checked the quality of the studies and extracted data. Eligible studies included single-arm studies and comparative studies. Weighted means, pooled event rates, efficacy outcomes and odds ratios (ORs) for immediate shunt reduction (ISR), presence of cardiogenic shock (CS), New York Heart Association (NYHA) class IV, time from AMI to ventricular septal defect (VSD), and time to VSD closure was estimated. Results A total of 27 single-arm articles (462 patients) were included. The pooled event rate was 89.7% (95% confidence interval [CI]: 0.772-1.021) for successful device implantation, 80.9% (95% CI: 0.645-0.972) for ISR, 31.5% (95% CI: 0.149-0.482) for 30-day mortality, and 25.3% (95% CI: 0.072-0.434) for 30-day mortality of primary closure at the acute phase. CS (OR = 3.607, 95% CI: 2.301-5.653), NYHA class IV (OR = 6.491, 95% CI: 1.444-29.188) and time to VSD closure were risk predictors for TCC. There was no correlation between defect size (OR = 2.592, 95% CI: 0.380-17.661) and mortality. Conclusion TCC should be a relatively safe and minimally invasive method for PIVSD, with an excellent successful device implantation rate and acceptable low 30-day mortality. The procedure appears promising, but its safety and efficacy could only be demonstrated by randomized controlled trials. Therefore, the mortality of data comparing surgery to TCC compels the need for future comparative trials.
第一作者机构:[1]Department of Obsterics Ultrasound, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650034, China[2]Department of Ultrasound Echocardiography, Yanan Hospital of Kunming City, Yunnan Cardiovascular Hospital, Kunming, Yunnan, 650233, China
共同第一作者:
通讯作者:
通讯机构:[5]Department of Cardiovascular Medicine, Sir Run Run Hospital Affiliated Nanjing Medical University, Nanjing, Jiangsu, 211166, China[*1]Department of Cardiovascular Medicine, Sir Run Run Hospital Affiliated Nanjing Medical University, 109 Long Mian Avenue, Jiangning District, Nanjing, 211166, China.
推荐引用方式(GB/T 7714):
Xiang Yang,Zeran Yu,Yu Wang,et al.Transcatheter closure for postinfarction ventricular septal defect: A meta-analysis of the current evidence[J].JOURNAL OF CARDIAC SURGERY.2021,36(12):4625-4633.doi:10.1111/jocs.15989.
APA:
Xiang Yang,Zeran Yu,Yu Wang,Yunchuan Ding,Ruizhi Ni&Pingxi Xiao.(2021).Transcatheter closure for postinfarction ventricular septal defect: A meta-analysis of the current evidence.JOURNAL OF CARDIAC SURGERY,36,(12)
MLA:
Xiang Yang,et al."Transcatheter closure for postinfarction ventricular septal defect: A meta-analysis of the current evidence".JOURNAL OF CARDIAC SURGERY 36..12(2021):4625-4633