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Open Access 01-12-2022 | Heart Valve Reconstruction | Research article

Transannular patch repair of tetralogy of Fallot with or without monocusp valve reconstruction: a meta-analysis

Authors: Xiaodong Wei, Tiange Li, Yunfei Ling, Zheng Chai, Zhongze Cao, Kerun Chen, Yongjun Qian

Published in: BMC Surgery | Issue 1/2022

Abstract

Background

Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases. Pulmonary regurgitation is the most common and severe comorbidity after transannular patch (TAP) repair of TOF patients. It has not been confirmed whether a TAP repair with monocusp valve reconstruction would benefit TOF patients in perioperative period compared to those without monocusp valve reconstruction. The purpose of the study is to review and analyze all clinical studies that have compared perioperative outcomes of TOF patients undergoing TAP repair with or without monocusp valve reconstruction and conduct a preferable surgery.

Methods

Eligible studies were identified by searching the electronic databases. The year of publication of studies was restricted from 2000 till present. The primary outcome was perioperative mortality, and secondary outcomes included cardiopulmonary bypass time, aortic cross-clamp time, ventilation duration, ICU length of stay, hospital length of stay, perioperative right ventricular outflow tract (RVOT) pressure gradient, and moderate or severe pulmonary regurgitation (PR). The meta-analysis and forest plots were drawn using Review Manager 5.3. Statistically significant was considered when p-value ≤ 0.05.

Results

Eight studies were included which consisted of 8 retrospective cohort study and 2 randomized controlled trial. The 10 studies formed a pool of 526 TOF patients in total, in which are 300 undergoing TAP repair with monocusp valve reconstruction (monocusp group) compared to 226 undergoing TAP repair without monocusp valve reconstruction (non-monocusp group). It demonstrated no significant differences between two groups in perioperative mortality (OR = 0.69, 95% CI 0.20–2.41, p = 0.58). It demonstrated significant differences in perioperative cardiopulmonary bypass time (minute, 95% CI 17.93–28.42, p < 0.00001), mean length of ICU stay (day, 95% CI − 2.11–0.76, p < 0.0001), and the degree of perioperative PR (OR = 0.03, 95% CI 0.010.12, p < 0.00001). Significant differences were not found in other secondary outcomes.

Conclusion

Transannular patch repair with monocusp valve reconstruction have significant advantages on decreasing length of ICU stay and reducing degree of PR for TOF patients. Large, multicenter, randomized, prospective studies which focuse on perioperative outcomes and postoperative differences based on long-term follow-up between TAP repair with and without monocusp valve reconstruction are needed.

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Title: Transannular patch repair of tetralogy of Fallot with or without monocusp valve reconstruction: a meta-analysis
Authors: Xiaodong Wei
Tiange Li
Yunfei Ling
Zheng Chai
Zhongze Cao
Kerun Chen
Yongjun Qian
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Heart Valve Reconstruction
Heart Valve Reconstruction
Heart Valve Reconstruction
Tetralogy of Fallot
Tetralogy of Fallot
Published in: BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-022-01474-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transannular patch repair of tetralogy of Fallot with or without monocusp valve reconstruction: a meta-analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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