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Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis

Wu, Xiangyang ; Wang, Cingting ; Du, Xinyuan ; Li, Yongnan ; He, Fengxiao ; Zhao, Qiming ; Mao, Yong

Revista brasileira de cirurgia cardiovascular, 2023-01, Vol.38 (4), p.e20220417-e20220417

Brazil: Sociedade Brasileira de Cirurgia Cardiovascular

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Título:
Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis
Autor: Wu, Xiangyang ; Wang, Cingting ; Du, Xinyuan ; Li, Yongnan ; He, Fengxiao ; Zhao, Qiming ; Mao, Yong
Assuntos: CARDIAC & CARDIOVASCULAR SYSTEMS ; Cardiac Catheterization - adverse effects ; Cardiac function ; Cardiac Surgical Procedures - adverse effects ; Cardiology ; Confidence intervals ; Coronary vessels ; Heart attacks ; Heart surgery ; Hospital Mortality ; Humans ; Meta-Analysis ; Mortality ; Myocardial Infarction ; Myocardial Infarction - complications ; Myocardial Infarction - surgery ; Retrospective Studies ; Review ; Risk Factors ; SURGERY ; Systematic review ; Treatment Outcome ; Treatment Outocome ; Veins & arteries ; Ventricular Septal Rupture ; Ventricular Septal Rupture - etiology ; Ventricular Septal Rupture - surgery
É parte de: Revista brasileira de cirurgia cardiovascular, 2023-01, Vol.38 (4), p.e20220417-e20220417
Notas: SourceType-Scholarly Journals-1
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ObjectType-Review-1
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Descrição: 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). 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. 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). We found that surgical repair appears to be a more effective therapeutic option than percutaneous closure for PI-VSR.
Editor: Brazil: Sociedade Brasileira de Cirurgia Cardiovascular
Idioma: Inglês;Português

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Percutaneous Closure vs. Surgical Repair for Postinfarction Ventricular Septal Rupture: A Systematic Review and Meta-Analysis

Wu, Xiangyang ; Wang, Cingting ; Du, Xinyuan ; Li, Yongnan ; He, Fengxiao ; Zhao, Qiming ; Mao, Yong

Brazil: Sociedade Brasileira de Cirurgia Cardiovascular

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