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Is Sutureless Technique Beneficial in the Primary Repair of Total Anomalous Pulmonary Venous Connection? A Systematic Review and Meta-Analysis

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Abstract

A meta-analysis was performed for a comparison of outcomes between sutureless technique and conventional surgery for primary repair for total anomalous pulmonary venous connection (TAPVC). Electronic databases including PubMed, EMbase, Scopus, and Cochrane Library were searched systematically for the single-arm studies regarding sutureless repair or conventional surgery, and two-arm studies compared the outcomes of sutureless repair and conventional surgery for TAPVC. Corresponding data were extracted and the methodological quality was assessed by two reviewers independently. 26 studies were included, involving a total of 2702 patients. It was observed that compared with conventional surgery, sutureless technique was associated with a lower occurrence rate of post-operative pulmonary veins obstruction (PVO) (4.6% vs. 13.5%, OR 0.54 in favor of sutureless technique) and re-operations due to PVO (3.4% vs. 12.4%, 0.25 in favor of sutureless technique). However, meta-analyses of post-operative early (OR 0.57; 95% CI 0.27–1.19; P = 0.13), late (OR 0.37; 95% CI 0.13–1.06; P = 0.13), and overall (OR 0.61; 95% CI 0.36–1.03; P = 0.07) mortality showed no significant difference between sutureless technique and conventional surgery. Compared with conventional surgery, sutureless technique was associated with a lower occurrence rate of post-operative PVO and re-operations due to PVO. Meanwhile, post-operative early, late, and overall mortality were not statistically different between two surgical approaches. Sutureless technique is beneficial in the primary repair of TAPVC regarding post-operative PVO and re-operations due to PVO. However, the level of evidence was low and randomized controlled trials should be designed to evaluate the safety and effectiveness of sutureless technique for TAPVC.

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Author notes

  1. Yuhao Wu and Liangjing Xin contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University, No. 136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, China

    Yuhao Wu, Yuehang Zhou, Xin Jin, Yonggang Li & Chun Wu

  2. Department of Orthodontics, Stomatological hospital of Chongqing Medical University, Chongqing, 400014, China

    Liangjing Xin

  3. Department of Cardiology, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China

    Hongyu Kuang

  4. Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China

    Yuhao Wu, Yuehang Zhou, Hongyu Kuang, Xin Jin, Yonggang Li & Chun Wu

  5. China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, 400014, China

    Yuhao Wu, Yuehang Zhou, Hongyu Kuang, Xin Jin, Yonggang Li & Chun Wu

  6. Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China

    Yuhao Wu, Yuehang Zhou, Hongyu Kuang, Xin Jin, Yonggang Li & Chun Wu

Authors
  1. Yuhao Wu
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  2. Liangjing Xin
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Correspondence to Chun Wu.

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Wu, Y., Xin, L., Zhou, Y. et al. Is Sutureless Technique Beneficial in the Primary Repair of Total Anomalous Pulmonary Venous Connection? A Systematic Review and Meta-Analysis. Pediatr Cardiol 40, 881–891 (2019). https://doi.org/10.1007/s00246-018-1948-y

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  • DOI: https://doi.org/10.1007/s00246-018-1948-y

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