Ductus Arteriosus Stent Compared with Surgical Shunt for Infants with Ductal-Dependent Pulmonary Blood Flow: A Systematic Review and Meta-Analysis

作     者：Sibao Wang Silin Pan Gang Luo Zhixian Ji Na Liu 

作者机构：Heart CenterQingdao Women and Children’s HospitalQingdao UniversityQingdao266034China 

出 版 物：《Congenital Heart Disease》 (先天性心脏病（英文）)

年 卷 期：2022年第17卷第1期

页      面：45-60页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Surgical shunt Blalock-Taussig shunt ductus arteriosus stents infants meta-analysis 

摘      要：The aim of this study was to perform a systematic review and meta-analysis to evaluate the safety and efficacy of ductus arteriosus stent(DAS)compared with surgical systemic-pulmonary artery shunt(SPS)in patients with ductal-dependent pulmonary blood flow.A literature search was conducted in PubMed,Embase,and the Cochrane Library databases from their inception to December *** reviewers independently screened the articles,evaluated the quality of the articles,and collected the ***-analyses were conducted using fixed and random effects *** used the I-square(I2)test to examine heterogeneity and the funnel plot Egger’s test was used to test for publication *** analyzed nine studies including 842 patients were included in the present study(DAS:n=295;SPS:n=547).There was a benefit in favor of DAS group for medium-term mortality(RR,0.63;95%CI,[0.40,0.99];P=0.91,I^(2)=0%).DAS group demonstrated a reduced risk for complications compared with SPS(RR,0.46;95%CI,[0.29,0.72];P=0.78,I^(2)=0%).There was an increased risk for unplanned reintervention for DAS(RR,1.77;95%CI,[1.42,2.20];P=0.61,I2=0%).DAS demonstrated shorter mean intensive care unit length of stay(MD,–5.12;95%CI,[–7.33,–2.91];P=0.005,I^(2)=76%).There was also demonstrated higher postprocedure oxygen saturation for SPS over DAS(MD,1.78;95% CI,[0.92,2.64];P=0.46,I2=0%).There was no difference between the two groups in terms of mortality within 30 days,Nakata Index,and hospital length of ***:In terms of initial palliative surgical in the ductal-dependent pulmonary blood flow,DAS demonstrated a lower risk of medium-term mortality,lower risk of complications,higher risk of unplanned reintervention,shorter ICU length of stay,and higher postprocedure oxygen saturation compared with SPS.