Open AccessCatheterization Therapy vs Surgical Closure in Pediatric Patients With Patent Ductus Arteriosus: A Meta‐Analysis
Author(s) -
Wang Kai,
Pan Xuanren,
Tang Qiaoyun,
Pang Yusheng
Publication year - 2014
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22238
Subject(s) - medicine , ductus arteriosus , relative risk , confidence interval , cochrane library , meta analysis , surgery , pediatrics
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.