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Pediatric Cardiology

, Volume 38, Issue 7, pp 1456–1464 | Cite as

Modified Single-Patch Technique Versus Two-Patch Technique for the Repair of Complete Atrioventricular Septal Defect: A Meta-Analysis

  • Dongxu Li
  • Qiang Fan
  • Tomoyuki Iwase
  • Yasutaka Hirata
  • Qi An
Original Article

Abstract

Technical selection for surgical repair of complete atrioventricular septal defect (CAVSD) still remains controversial. This meta-analysis aimed to compare the modified single-patch (MP) technique with the two-patch (TP) technique for patients with CAVSD. Relevant studies comparing the MP technique with the TP technique were identified through a literature search using MEDLINE, EMBASE, Google Scholar, Cochrane Library, and the China National Knowledge Infrastructure databases. The variables were ventricular septal defect (VSD) size, cardiopulmonary bypass (CBP) time, aortic cross-clamp (ACC) time, intensive care unit stay, hospital stay, and other outcomes involving mortality, left ventricular outflow tract obstruction, atrioventricular valve regurgitation, residual septal shunt, atrioventricular block, and reoperation. A random-effect/fixed-effect model was used to summarize the estimates of mean difference/odds ratio with 95% confidence interval. Subgroup analysis stratified by region was performed. Fifteen publications involving 1034 patients were included. This meta-analysis demonstrated that (1) VSD size in the MP group was significantly smaller; (2) CBP time, ACC time, and hospital stay in the MP group experienced improvement; (3) Other postoperative outcomes showed no significant differences between two groups; and (4) The trends in China and other countries were close. The MP and TP techniques had comparable outcomes; however, the MP technique was performed with significantly shorter CBP and ACC times in patients with smaller VSDs. Given this limitation of data, the results of comparison of the two techniques in patients with larger VSDs remain unknown. Further studies are needed.

Keywords

Complete atrioventricular septal defect Modified single-patch technique Two-patch technique Meta-analysis 

Notes

Acknowledgments

Dongxu Li was supported by grants from the China Scholarship Council.

Compliance with Ethical Standards

Conflict of interest

The authors report no conflicts of interest regarding the content herein.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

246_2017_1684_MOESM1_ESM.tif (610 kb)
Supplementary material 1 (TIFF 609 kb) Fig. e6 Forest plots and subgroup analysis for MD of ICU stay in CAVSD patients with MP technique versus TP technique
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Supplementary material 2 (TIFF 1558 kb) Fig. e7 Forest plots and subgroup analysis for ORs of early mortality (a) and overall mortality (b) in CAVSD patients with MP technique versus TP technique
246_2017_1684_MOESM3_ESM.tif (1.4 mb)
Supplementary material 3 (TIFF 1430 kb) Fig. e8 Forest plots and subgroup analysis for ORs of LVOTO (a) and residual septal defects (b) in CAVSD patients with MP technique versus TP technique
246_2017_1684_MOESM4_ESM.tif (1.5 mb)
Supplementary material 4 (TIFF 1506 kb) Fig. e9 Forest plots and subgroup analysis for ORs of complete AVB (a) and overall reoperation (b) in CAVSD patients with MP technique versus TP technique
246_2017_1684_MOESM5_ESM.tif (2.3 mb)
Supplementary material 5 (TIFF 2317 kb) Fig. e10 Forest plots and subgroup analysis for MDs of the grades of LAVV regurgitation (a) and RAVV regurgitation (b) in CAVSD patients with MP technique versus TP technique

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Cardiovascular Surgery, West China HospitalSichuan UniversityChengduPeople’s Republic of China
  2. 2.Department of Cardiac SurgeryThe University of Tokyo HospitalTokyoJapan

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