Surgical Management for Complete Atrioventricular Septal Defects: A Systematic Review and Meta-Analysis
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ORIGINAL ARTICLE
Surgical Management for Complete Atrioventricular Septal Defects: A Systematic Review and Meta‑Analysis Yuhao Wu1,2 · Hongyu Kuang3 · Gang Wang1,2 · Jiangtao Dai1,2 · Yonggang Li2 · Guanghui Wei2 · Chun Wu1,2 Received: 31 March 2020 / Accepted: 12 June 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract A meta-analysis is performed for a comparison of outcomes between the modified one-patch repair (MPR) and two-patch repair (TPR) for complete atrioventricular septal defects (CAVSD). Electronic databases, including PubMed, Scopus, Embase, and Cochrane Library were searched systematically for the literature which aimed mainly at comparing the therapeutic effects for CAVSD administrated by MPR and TPR. Corresponding data sets were extracted and two reviewers independently assessed the risks of bias. Meta-analysis was performed using Revman 5.3 and Stata 12.0. Fifteen studies meeting the inclusion criteria were included, involving 2076 subjects in total. It was observed that MPR was associated with shorter cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) times, as compared with TPR. However, no statistical differences were found in terms of size of ventricular septal defects (VSD), reoperation, mortality, implantation of permanent pacemakers, and length of ventilation, hospital and intensive care unit stay. As compared with TPR, MPR is superior in terms of ACC and CPB. However, with regard to reoperation, mortality, length of ventilation, ICU and hospital stay and permanent pacemakers implantation, no significant differences are found between these two procedures. MPR is likely to apply to younger infants with faster completion of surgery. Surgery is recommended between 3 and 6 months of age. Keywords Atrioventricular septal defects · Surgery · Outcomes Abbreviations CAVSD Complete atrioventricular septal defect TPR Two-patch repair MPR Modified one-patch repair Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00246-020-02397-w) contains supplementary material, which is available to authorized users. * Guanghui Wei [email protected] * Chun Wu [email protected] 1
Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University, No.136 Zhongshan Second Road, Yuzhong District, Chongqing 400014, China
2
Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
3
Department of Cardiology, Chongqing Medical University Affiliated Second Hospital, Chongqing, China
VSD Ventricular septal defect AVVR Atrioventricular valve regurgitation LVOTO Left ventricular outflow tract obstruction ICU Intensive care unit LOS Length of hospital stay ACC Aortic cross-clamp time, CPB Cardiopulmonary bypass time ZOA Zone of apposition
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