Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis
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Sociedade Brasileira de Cirurgia Cardiovascular
2023
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| author | Xiangyang Wu |
| author_facet | Xiangyang Wu |
| contents | Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis Xiangyang Wu Cingting Wang Xinyuan Du Yongnan Li Fengxiao He Qiming Zhao Yong Mao Medicina meta Analysis risk Factors treatment Outocome Myocardial Infarction Introduction: Ventricular septal rupture is an important high-mortality complication in the scope of myocardial infarctions. The effectiveness of different treatment modalities is still controversial. This meta-analysis compares the efficacy of percutaneous closure vs. surgical repair for the treatment of postinfarction ventricular septal rupture (PI-VSR). Methods: A meta-analysis was performed on relevant studies found through PubMed®, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (or CNKI), Wanfang Data, and VIP databases searching. The primary outcome was a comparison of in-hospital mortality between the two treatments, and the secondary outcome was documentation of one-year mortality, postoperative residual shunts, and postoperative cardiac function. Differences were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) to assess the relationships between predefined surgical variables and clinical outcomes. Results: Qualified studies (742 patients from 12 trials) were found and investigated for this meta-analysis (459 patients in the surgical repair group, 283 patients in the percutaneous closure group). When comparing surgical repair to percutaneous closure, it was found that the former significantly reduced in-hospital mortality (OR: 0.67, 95% CI 0.48–0.96, P=0.03) and postoperative residual shunts (OR: 0.03, 95% CI 0.01–0.10, P<0.00001). Surgical repair also improved postoperative cardiac function overall (OR: 3.89, 95% CI 1.10–13.74, P=0.04). However, there was no statistically significant difference in one-year mortality between the two surgical strategies (OR: 0.58, 95% CI 0.24–1.39, P=0.23). Conclusion: We found that surgical repair appears to be a more effective therapeutic option than percutaneous closure for PI-VSR. 2023 reseña 0102-7638 https://www.redalyc.org/articulo.oa?id=398975374011 https://www.redalyc.org/journal/3989/398975374011/ https://www.redalyc.org/journal/3989/398975374011/html/ https://www.redalyc.org/journal/3989/398975374011/398975374011.epub https://www.redalyc.org/journal/3989/398975374011/movil 10.21470/1678-9741-2022-0417 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.38 |
| format | Artículo científico |
| id | redalyc_398975374011 |
| institution | Redalyc |
| language | en |
| publishDate | 2023 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis Xiangyang Wu Medicina meta Analysis risk Factors treatment Outocome Myocardial Infarction Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis Xiangyang Wu Cingting Wang Xinyuan Du Yongnan Li Fengxiao He Qiming Zhao Yong Mao Medicina meta Analysis risk Factors treatment Outocome Myocardial Infarction Introduction: Ventricular septal rupture is an important high-mortality complication in the scope of myocardial infarctions. The effectiveness of different treatment modalities is still controversial. This meta-analysis compares the efficacy of percutaneous closure vs. surgical repair for the treatment of postinfarction ventricular septal rupture (PI-VSR). Methods: A meta-analysis was performed on relevant studies found through PubMed®, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (or CNKI), Wanfang Data, and VIP databases searching. The primary outcome was a comparison of in-hospital mortality between the two treatments, and the secondary outcome was documentation of one-year mortality, postoperative residual shunts, and postoperative cardiac function. Differences were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) to assess the relationships between predefined surgical variables and clinical outcomes. Results: Qualified studies (742 patients from 12 trials) were found and investigated for this meta-analysis (459 patients in the surgical repair group, 283 patients in the percutaneous closure group). When comparing surgical repair to percutaneous closure, it was found that the former significantly reduced in-hospital mortality (OR: 0.67, 95% CI 0.48–0.96, P=0.03) and postoperative residual shunts (OR: 0.03, 95% CI 0.01–0.10, P<0.00001). Surgical repair also improved postoperative cardiac function overall (OR: 3.89, 95% CI 1.10–13.74, P=0.04). However, there was no statistically significant difference in one-year mortality between the two surgical strategies (OR: 0.58, 95% CI 0.24–1.39, P=0.23). Conclusion: We found that surgical repair appears to be a more effective therapeutic option than percutaneous closure for PI-VSR. 2023 reseña 0102-7638 https://www.redalyc.org/articulo.oa?id=398975374011 https://www.redalyc.org/journal/3989/398975374011/ https://www.redalyc.org/journal/3989/398975374011/html/ https://www.redalyc.org/journal/3989/398975374011/398975374011.epub https://www.redalyc.org/journal/3989/398975374011/movil 10.21470/1678-9741-2022-0417 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.38 |
| title | Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis |
| topic | Medicina meta Analysis risk Factors treatment Outocome Myocardial Infarction |
| url | https://www.redalyc.org/articulo.oa?id=398975374011 https://www.redalyc.org/journal/3989/398975374011/ https://www.redalyc.org/journal/3989/398975374011/html/ https://www.redalyc.org/journal/3989/398975374011/398975374011.epub https://www.redalyc.org/journal/3989/398975374011/movil |