Transcatheter Closure vs Surgical Closure of Ventricular Septal Defect in China: A Meta-Analysis
Abstract
Objective: To compare the curative effect, safety and medical cost of transcatheter closure and surgical closure in ventricular septal defect in China,so as to provide references for treatment plans of ventricular septal defect in clinic medicine.
Methods: Chinese literature databases such as CBM, VIP, CNKI, Wan Fang and English literature databases such as PubMed, Ovid and EBSCO were searched from the date of their establishment to June 2015 for collecting the related articles, the collected articles were screened, extracted, evaluated, and analyzed by using Revman5. 3 software.
Results: 23 articles (16 Chinese articles, 7 English articles) met the inclusion criteria,transcatheter closure (TC) group included 2801 cases,surgical closure (SC) group included 3,086 cases. Meta-analysis results showed as following:(a) operation success rate:TC group was lower than SC group (RR=0.98, 95% CI=0.96~0.99, P = 0.008);(b) operation complication rate:TC group was lower than SC group (RR=0.62, 95% CI=0.46~0.84, P=0.002);(c) operation immediate residual shunt rate:TC group was lower than SC group (RR=0.69, 95% CI = 0.51~ 0.95, P=0.02);(d) operation time:TC group was shorter than SC group (SMD= -2.87, 95% CI = -3.60 ~ -2.13, P<0.00001);(e) length of hospital stay:TC group was shorter than SC group (SMD= -1.55, 95% CI=-2.14 ~ -0.95, P<0.00001);(6) hospitalization expenses:TC group was higher than SC group (SMD=1.02, 95% CI=0.12~1.93, P=0.03).
Conclusion: TC is lower than SC in operation success rate,operation complication rate and operation immediate residual shunt rate; and TC is shorter than SC in operation time and length of hospital stay;but TC is higher than SC in the hospitalization expenses. Thus, transcatheter closure can be used as an alternative to surgical treatment in the range of indication.
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DOI: http://dx.doi.org/10.3968/%25x
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