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Review
. 2014 Mar;37(3):188-94.
doi: 10.1002/clc.22238. Epub 2014 Jan 6.

Catheterization therapy vs surgical closure in pediatric patients with patent ductus arteriosus: a meta-analysis

Kai Wang  1 , Xuanren Pan, Qiaoyun Tang, Yusheng Pang
Affiliations
Review

Catheterization therapy vs surgical closure in pediatric patients with patent ductus arteriosus: a meta-analysis

Kai Wang et al. Clin Cardiol. 2014 Mar.

Abstract

Background: Patent ductus arteriosus (PDA) remains a common congenital heart disease in pediatric patients, and the new trend of catheterization therapy is still associated with some potential risks and complications.

Hypothesis: Compared with surgical closure, the clinical effect of catheterization therapy in pediatric PDA patients requires meta-analysis.

Methods: A systematic literature search of PubMed, Cochrane Library, Embase, Science Citation Index, Web of Science, and the Chinese Biomedicine literature database was conducted. Eligible studies included controlled trials of pediatric PDA patients receiving catheterization therapy vs surgical closure. Relative risks (RRs), standard mean differences, and 95% confidence intervals (CIs) were calculated and heterogeneity was assessed with the I(2) test.

Results: Seven studies with a total of 810 patients met the inclusion criteria. Catheterization therapy neither significantly increased the primary success rate (RR: 0.92, 95% CI: 0.82-1.03, P = 0.16) nor reduced the total postprocedure complications (RR: 0.74, 95% CI: 0.44-1.25, P = 0.26) and blood transfusion (RR: 1.10, 95% CI: 0.16-7.67, P = 0.93). Catheterization was associated with a statistically significant increase in residual shunts (RR: 5.19, 95% CI: 1.41-19.20, P = 0.01) and reduction in length of hospital stay (standard mean difference: -1.66, 95% CI: -2.65 to -0.67, P = 0.001).

Conclusions: Catheterization therapy in pediatric PDA patients did not show a significant advantage in primary success rate, total complications, or blood transfusion, but it was associated with increase in residual shunts and reduction in length of hospital stay.

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Figures

Figure 1
Figure 1
Flow chart of article screening and selection process.
Figure 2
Figure 2
Forest plot showing (A) the primary success rate and (B) postprocedure complications between the catheterization and surgical repair groups. Abbreviations: CI, confidence interval; M‐H, Mantel‐Haenszel.
Figure 3
Figure 3
Forest plot showing (A) the residual shunt, (B) blood transfusion, and (C) length of hospital stay between the catheterization and surgical repair groups. Abbreviations: CI, confidence interval; M‐H, Mantel‐Haenszel.
Figure 4
Figure 4
Funnel plot for primary success rate. Abbreviations: RR, relative risk.
See this image and copyright information in PMC

References

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