Efficacy and safety of the interventional therapy and surgical repair for atrial septal defects: a systematic review

Abstract:

Objective：To evaluate the efficiency and safety of transcatheter closure and surgical repair for atrial septal defect（ASD） using systematic review method and to provide references for clinical treatment. Methods：The CBM，CNKI，WanFang Med Online and VIP were searched for all controlled trials. Screening，quality evaluation and information extraction were carried out on the studies according to including and excluding standard. The software RevMan 5.2 was used for data analysis. Results：Thirteen included studies were not randomized controlled trials，984 cases in intervention group and 890 cases in surgery group. The combined results showed that the procedural success rate of transcatheter closure group was lower than that of surgery group（13 controlled trails，96.64% vs. 99.66%，RR=0.97，95%CI=0.96 to 0.98，P=0.000）. Although the instant residual shunt rate was higher in transcatheter closure group than in surgery group（10 controlled trails，2.31% vs. 1.70%，RR=1.45，95%CI=0.75 to 2.82，P=0.270），the total complication rate was lower in transcatheter closure group than that in surgery group（12 controlled trails，6.07% vs. 20.26%，RR=0.29，95%CI=0.22 to 0.39，P=0.000）. Conclusion：Transcatheter closure of patent ductus arteriosus is an ideal procedure within acceptable limits owing to its reliability，safety，min-invasiveness and short hospitalization.