PMID- 34499370
OWN - NLM
STAT- MEDLINE
DCOM- 20211102
LR  - 20211102
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 36
IP  - 12
DP  - 2021 Dec
TI  - Transcatheter closure for postinfarction ventricular septal defect: A 
      meta-analysis of the current evidence.
PG  - 4625-4633
LID - 10.1111/jocs.15989 [doi]
AB  - OBJECTIVE: Postinfarction ventricular septal defect (PIVSD) is a severe 
      complication of acute myocardial infarction (AMI). Transcatheter closure (TCC) is 
      an alternative option to surgical repair. This study was undertaken to examine 
      the published literature to provide objective evidence for TCC using a 
      meta-analysis. METHODS: We searched for significant medical and publisher 
      databases. Two reviewers checked the quality of the studies and extracted data. 
      Eligible studies included single-arm studies and comparative studies. Weighted 
      means, pooled event rates, efficacy outcomes and odds ratios (ORs) for immediate 
      shunt reduction (ISR), presence of cardiogenic shock (CS), New York Heart 
      Association (NYHA) class IV, time from AMI to ventricular septal defect (VSD), 
      and time to VSD closure was estimated. RESULTS: A total of 27 single-arm articles 
      (462 patients) were included. The pooled event rate was 89.7% (95% confidence 
      interval [CI]: 0.772-1.021) for successful device implantation, 80.9% (95% CI: 
      0.645-0.972) for ISR, 31.5% (95% CI: 0.149-0.482) for 30-day mortality, and 25.3% 
      (95% CI: 0.072-0.434) for 30-day mortality of primary closure at the acute phase. 
      CS (OR = 3.607, 95% CI: 2.301-5.653), NYHA class IV (OR = 6.491, 95% CI: 
      1.444-29.188) and time to VSD closure were risk predictors for TCC. There was no 
      correlation between defect size (OR = 2.592, 95% CI: 0.380-17.661) and mortality. 
      CONCLUSION: TCC should be a relatively safe and minimally invasive method for 
      PIVSD, with an excellent successful device implantation rate and acceptable low 
      30-day mortality. The procedure appears promising, but its safety and efficacy 
      could only be demonstrated by randomized controlled trials. Therefore, the 
      mortality of data comparing surgery to TCC compels the need for future 
      comparative trials.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Yang, Xiang
AU  - Yang X
AUID- ORCID: 0000-0003-4093-4978
AD  - Department of Obsterics Ultrasound, The First People's Hospital of Yunnan 
      Province, The Affiliated Hospital of Kunming University of Science and 
      Technology, Kunming, Yunnan, 650034, China.
AD  - Department of Ultrasound Echocardiography, Yanan Hospital of Kunming City, Yunnan 
      Cardiovascular Hospital, Kunming, Yunnan, 650233, China.
FAU - Yu, Zeran
AU  - Yu Z
AUID- ORCID: 0000-0003-2236-6989
AD  - Department of Neurosurgery, The Affiliated Hospital of Yunnan University, The 
      Second People's Hospital of Yunnan, Kunming, Yunnan, 650021, China.
FAU - Wang, Yu
AU  - Wang Y
AUID- ORCID: 0000-0003-2377-9769
AD  - Department of Cardiovascular Medicine, First Affiliated Hospital of Kunming 
      Medical University, Kunming, Yunnan, 650032, China.
FAU - Ding, Yunchuan
AU  - Ding Y
AD  - Department of Ultrasound Echocardiography, Yanan Hospital of Kunming City, Yunnan 
      Cardiovascular Hospital, Kunming, Yunnan, 650233, China.
FAU - Ni, Ruizhi
AU  - Ni R
AD  - Department of Cardiovascular Medicine, First Affiliated Hospital of Kunming 
      Medical University, Kunming, Yunnan, 650032, China.
FAU - Xiao, Pingxi
AU  - Xiao P
AUID- ORCID: 0000-0003-0633-0978
AD  - Department of Cardiovascular Medicine, Sir Run Run Hospital Affiliated Nanjing 
      Medical University, Nanjing, Jiangsu, 211166, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210909
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Cardiac Catheterization
MH  - *Heart Septal Defects, Ventricular/surgery
MH  - Humans
MH  - *Myocardial Infarction/complications
MH  - *Septal Occluder Device
MH  - Shock, Cardiogenic
MH  - Treatment Outcome
OTO - NOTNLM
OT  - acute myocardial infarction
OT  - meta-analysis
OT  - postinfarction ventricular septal defect
OT  - transcatheter closure
EDAT- 2021/09/10 06:00
MHDA- 2021/11/03 06:00
CRDT- 2021/09/09 12:34
PHST- 2021/08/08 00:00 [received]
PHST- 2021/08/17 00:00 [accepted]
PHST- 2021/09/10 06:00 [pubmed]
PHST- 2021/11/03 06:00 [medline]
PHST- 2021/09/09 12:34 [entrez]
AID - 10.1111/jocs.15989 [doi]
PST - ppublish
SO  - J Card Surg. 2021 Dec;36(12):4625-4633. doi: 10.1111/jocs.15989. Epub 2021 Sep 9.