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Comparing clinical and echocardiographic outcomes following valve-sparing versus transannular patch repair of tetralogy of Fallot: a systematic review and meta-analysis.
Martins, Russell Seth; Fatimi, Asad Saulat; Mahmud, Omar; Qureshi, Saleha; Nasim, Muhammad Taha; Virani, Sehar Salim; Tameezuddin, Aimen; Yasin, Fatima; Malik, Mahim Akmal.
Afiliación
  • Martins RS; Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian School of Medicine and Hackensack Meridian Health Network, Edison, NJ, USA.
  • Fatimi AS; Medical College, Aga Khan University, Karachi, Pakistan.
  • Mahmud O; Medical College, Aga Khan University, Karachi, Pakistan.
  • Qureshi S; Medical College, Aga Khan University, Karachi, Pakistan.
  • Nasim MT; Medical College, Aga Khan University, Karachi, Pakistan.
  • Virani SS; Department of Surgery, Aga Khan University, Karachi, Pakistan.
  • Tameezuddin A; Medical College, Ziauddin University, Karachi, Pakistan.
  • Yasin F; Medical College, Aga Khan University, Karachi, Pakistan.
  • Malik MA; Department of Cardiac Surgery, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan.
Interdiscip Cardiovasc Thorac Surg ; 39(1)2024 Jul 03.
Article en En | MEDLINE | ID: mdl-38924512
ABSTRACT

OBJECTIVES:

Transannular patch (TAP) repair of tetralogy of Fallot (ToF)relieves right ventricular tract obstruction but may lead to pulmonary regurgitation. Valve-sparing (VS) procedures can avoid this situation, but there is a potential for residual pulmonary stenosis. Our goal was to evaluate clinical and echocardiographic outcomes of TAP and VS repair for ToF.

METHODS:

A systematic search of the PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials and Web of Science databases was carried out to identify articles comparing conventional TAP repair and VS repair for ToF. Random-effects models were used to perform meta-analyses of the clinical and echocardiographic outcomes.

RESULTS:

Forty studies were included in this meta-analysis with data on 11 723 participants (TAP 6171; VS 5045). Participants who underwent a VS procedure experienced a significantly lower cardiopulmonary bypass time [mean difference (MD) -14.97; 95% confidence interval (CI) -22.54, -7.41], shorter ventilation duration (MD -15.33; 95% CI -30.20, -0.46) and shorter lengths of both intensive care unit (ICU) (MD -0.67; 95% CI -1.29, -0.06) and hospital stays (MD -2.30; 95% CI [-4.08, -0.52). There was also a lower risk of mortality [risk ratio 0.40; 95% CI (0.27, 0.60) and pulmonary regurgitation [risk ratio 0.35; 95% CI (0.26, 0.46)] associated with the VS group. Most other clinical and echocardiographic outcomes were comparable in the 2 groups.

CONCLUSIONS:

This meta-analysis confirms the well-established increased risk of pulmonary insufficiency following TAP repair while also demonstrating that VS repairs are associated with several improved clinical outcomes. Continued research can identify the criteria for adopting a VS approach as opposed to a traditional TAP repair.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Interdiscip Cardiovasc Thorac Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Interdiscip Cardiovasc Thorac Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido