IMR Press / RCM / Volume 23 / Issue 8 / DOI: 10.31083/j.rcm2308262
Open Access Systematic Review
Midterm Results Comparing Perventricular Device Closure with Surgical Repair for Isolated Congenital Ventricular Septal Defects: A Systematic Review and Meta-Analysis
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1 School of Medicine, South China University of Technology, 510641 Guangzhou, Guangdong, China
2 Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 510260 Guangzhou, Guangdong, China
3 Department of Cardiovascular Intensive Care Unit, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 510260 Guangzhou, Guangdong, China
4 Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510260 Guangzhou, Guangdong, China
*Correspondence: zhuangjian5413@163.com (Jian Zhaung)
These authors contributed equally.
Academic Editors: Salvatore De Rosa and Matteo Bertini
Rev. Cardiovasc. Med. 2022, 23(8), 262; https://doi.org/10.31083/j.rcm2308262
Submitted: 15 April 2022 | Revised: 12 May 2022 | Accepted: 10 June 2022 | Published: 20 July 2022
(This article belongs to the Section Cardiovascular Intervention and Therapeutics)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: This systematic review and meta-analysis aimed at comparing the midterm outcomes of perventricular device closure (PDC) with conventional surgical repair (CSR) for VSD. Methods: PubMed, Cochrane Library, and Web of Science databases were searched from January 1, 2005, to October 15, 2020, for English or Chinese language studies comparing outcomes of PDC with CSR for VSD. The midterm results were assessed as a primary outcome. A systematic review and meta-analysis was performed under the frequentist frame with risk ratio (RR) and 95% confidence interval (CI). Results: A total of 4381 patients (PDC = 2016, CSR = 2365) from 15 studies were included. The pooled estimates of success rate favored the CSR compared with the PDC (RR, 0.97; 95% CI, 0.96 to 0.99; p = 0.001). No significant differences in minor complications or severe complications were found between the PDC and CSR (RR, 0.79; 95% CI, 0.50 to 1.23; p = 0.29; RR, 1.43; 95% CI, 0.74 to 2.75; p = 0.29). The pooled estimates of residual shunts favored the PDC compared with the CSR (RR, 9.07; 95% CI, 4.77 to 17.24; p < 0.001), the pooled estimates of aortic regurgitation favored the CSR compared with the PDC (RR, 1.59; 95% CI, 1.05 to 2.39; p = 0.03). Conclusions: PDC is a safe and effective procedure with less surgical injury and shorter perioperative hospital stay. However, aortic regurgitation is a concern during follow-up.

Keywords
ventricular septal defect
perventricular device closure
conventional surgical repair
meta-analysis
aortic regurgitation
Funding
2019B020230003/Science and Technology Planning Project of Guangdong Province
DFJH201802/Guangdong Peak Project
2018B090944002/Science and Technology Planning Project of Guangdong Province
2020B1111170011/Science and Technology Planning Project of Guangdong Province
DFJH201802/Guangdong peak project
2018YFC100168/National Key Research and Development Program
Figures
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