Transcatheter versus surgical closure of secundum atrial septal defects:a systematic review and meta-analysis
摘要Background Transcatheter closure and surgical closure of secundum atrial septal defects(SASDs)are com-mon treatment methods.It is not clear which method has a more obvious technical advantage.Objective To sum-marise data from studies comparing transcatheter closure versus surgical closure of SASDs.Methods Databases including PubMed,EMbase,Web of science,Cochrane Library,CBM,CNKI and Wanfang databases were searched to enroll randomized controlled trials and cohort study trials comparing the two treatment methods(trans-catheter closure versus surgical closure).The literature was screened according to the inclusive and exclusive crite-ria by two reviewers independently.The quality of the trials was evaluated.The data were extracted and meta-analy-sis was performed using RevMan 5.3 software.Results 29 original studies(14,941 patients)were included.All studies were non-random.Transcatheter closure was found to be superior to surgical closure in the following out-comes:all-cause mortality(OR 0.36,95%CI 0.21~0.59,P<0.0001),total complications(OR 0.37,95%CI 0.25~0.55,P<0.00001),and hospital stay length(WMD-3.77,95%CI-4.36~-3.18,P<0.00001).Residual shunts inci-dence and retreatment incidence were more common in the transcatheter closure group than those in the surgical closure group[(OR 3.55,95%CI 1.79~7.05,P=0.0003)and(OR 2.19,95%CI 1.31~3.65,P=0.003),respectively].Conclusions Both approaches are effective for closure SASDs.Transcatheter is associated with lower mortality,complications and hospital stay length,while surgical closure has incidence of residual shunting and retreatment.[S Chin J Cardiol 2023;24(3):146-157]
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