Percutaneous versus surgical closure of secundum atrial septal defects: a systematic review and meta-analysis of currently available clinical evidence

2011 ◽  
Vol 7 (3) ◽  
pp. 377-385 ◽  
Author(s):  
Gianfranco Butera ◽  
Giuseppe Biondi-Zoccai ◽  
Giuseppe Sangiorgi ◽  
Raul Abella ◽  
Alessandro Giamberti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Evidence ◽  
Meta Analysis ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

Treatment options for the closure of secundum atrial septal defects: A systematic review and meta-analysis

2017 ◽  
Vol 241 ◽  
pp. 149-155 ◽  
Author(s):  
Pedro A. Villablanca ◽  
David A. Briston ◽  
Josep Rodés-Cabau ◽  
David F. Briceno ◽  
Gaurav Rao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Options ◽  
Septal Defects ◽  
Atrial Septal Defects

Transcatheter versus surgical closure of atrial septal defects: a systematic review and meta-analysis of clinical outcomes

2021 ◽  
pp. 1-9
Author(s):  
Aimee-Louise Chambault ◽  
Kathryn Olsen ◽  
Louise J. Brown ◽  
Sophie L. Mellor ◽  
Nilofer Sorathia ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hospital Stay ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Mean Difference ◽  
Complication Rates ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Significant Difference

Abstract Background: Atrial septal defects are a common form of CHD and dependent on the size and nature of atrial septal defects, closure may be warranted. The paper aims to compare outcomes of transcatheter versus surgical repair of atrial septal defects. Methods: A comprehensive electronic literature search was conducted. Primary studies were included if they compared both closure techniques. Primary outcomes included procedural success, mortality, and reintervention rate. Secondary outcomes included residual defect and mean hospital stay. Results: A total of 33 studies were included in meta-analysis. Mean total hospital stay was significantly shorter in the transcatheter cohort across both the adult (95% confidence interval, mean difference −4.05 (−4.78, −3.32) p < 0.00001) and paediatric populations (95% confidence interval, mean difference −4.78 (−5.97, −3.60) p < 0.00001). There were significantly fewer complications in the transcatheter group across both the adult (odds ratio 0.45, 95% confidence interval, [0.28, 0.72], p < 0.00001) and paediatric cohorts (odds ratio 0.26, 95% confidence interval, [0.14, 0.49], p < 0.00001). No significant difference in overall mortality was found between transcatheter versus surgical closure across the two groups, adult (odds ratio 0.76, 95% confidence interval, [0.40, 1.45], p = 0.41), paediatrics (odds ratio 0.62, 95% confidence interval, [0.21, 1.83], p = 0.39). Conclusion: Both transcatheter and surgical approaches are safe and effective techniques for atrial septal defect closure. Our study has demonstrated the benefits of transcatheter closure in terms of lower complication rates and mean hospital stay. However, surgery still has a place for more complex closure and, as we have demonstrated, shows no difference in mortality.

scholarly journals Minimally invasive versus transcatheter closure of secundum atrial septal defects: a systematic review and meta-analysis

Perfusion ◽  
2021 ◽  
pp. 026765912110219
Author(s):  
Esther Goh ◽  
Haya Mohammed ◽  
Mohammad Yusuf Salmasi ◽  
Samantha Ho ◽  
Umberto Benedetto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Observational Studies ◽  
Transcatheter Closure ◽  
Meta Analysis ◽  
Limited Data ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Operative Outcomes ◽  
Asd Closure

Background: Limited data exists demonstrating the efficacy of minimally invasive surgery (MIS) compared to transcatheter (TC) closure of atrial septal defects (ASD). This systematic review and meta-analysis aims to compare post-operative outcomes of MIS versus TC repair in ASD closure. Methods: PubMed, Medline and EMBASE were searched from inception until June 2018 for randomised and observational studies comparing post-operative outcomes for MIS and TC repair. The studies were reviewed for bias using the ROBINS-I Score and pooled in a meta-analysis using STATA (version 15). Results: Six observational studies, involving 1524 patients assessing three primary and five secondary outcomes were included. Evidence suggests TC repair yielded shorter hospital stay (MD = 3.32, 95% CI 1.04–5.60) and lower rates of transient atrial fibrillation (AF) (RR = 0.48, 95% CI 0.20–1.15). TC repair patients also had fewer pericardial effusions (RR = 0.27, 95% CI 0.05–1.54, I2 = 0.0%) and pneumothoraxes (RR = 0.18, 95% CI 0.04–0.80, I2 = 0.0%). However, TC repair results in more minor residual shunts (RR = 6.04, 95% CI 1.69–21.63 in favour of MIS, I2 = 39.0%). No differences were found for incidences of strokes (RR = 1.58, 95% CI 0.23–10.91, I2 = 19.3%), unexpected bleeding (RR = 0.44, 95% CI 0.19–1.04, I2 = 0.0%) and blood transfusion (RR = 0.39, 95% CI 0.09–1.59, I2 = 0.0%). Conclusions: MIS closure for ASD has similar outcomes compared to TC repair. However, the lack of randomised literature related to MIS versus TC repair for ASD closure warrants further evidence in the form of RCTs to further support these findings.

Minimally Invasive Surgery vs Device Closure for Atrial Septal Defects: A Systematic Review and Meta-analysis

2020 ◽  
Vol 41 (5) ◽  
pp. 853-861 ◽  
Author(s):  
Konstantinos S. Mylonas ◽  
Ioannis A. Ziogas ◽  
Alexandros Evangeliou ◽  
Pouya Hemmati ◽  
Dimitrios Schizas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Meta Analysis ◽  
Device Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

scholarly journals Inhibition of Androgen Signalling Improves the Outcomes of Therapies for Bladder Cancer: Results from a Systematic Review of Preclinical and Clinical Evidence and Meta-Analysis of Clinical Studies

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 351
Author(s):  
Massimiliano Creta ◽  
Giuseppe Celentano ◽  
Luigi Napolitano ◽  
Roberto La Rocca ◽  
Marco Capece ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bladder Cancer ◽  
Relative Risk ◽  
Clinical Studies ◽  
Clinical Evidence ◽  
Meta Analysis ◽  
Bladder Tumour ◽  
Signalling Pathways ◽  
Reductase Inhibitors ◽  
The Impact

Bladder cancer (BCa) is an endocrine-related tumour and the activation of androgen signalling pathways may promote bladder tumorigenesis. We summarized the available preclinical and clinical evidence on the implications of the manipulation of androgen signalling pathways on the outcomes of BCa therapies. A systematic review was performed in December 2020. We included papers that met the following criteria: original preclinical and clinical research; evaluating the impact of androgen signalling modulation on the outcomes of BCa therapies. Six preclinical and eight clinical studies were identified. The preclinical evidence demonstrates that the modulation of androgen receptor-related pathways has the potential to interfere with the activity of the Bacillus Calmette Guerin, doxorubicin, cisplatin, gemcitabine, and radiotherapy. The relative risk of BCa recurrence after transurethral resection of the bladder tumour (TURBT) is significantly lower in patients undergoing therapy with 5 alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT) (Relative risk: 0.50, 95% CI: 0.30–0.82; p = 0.006). Subgroup analysis in patients receiving 5-ARIs revealed a relative risk of BCa recurrence of 0.46 (95% CI: 0.22–0.95; p = 0.040). A significant negative association between the ratio of T1 BCa patients in treated/control groups and the relative risk of BCa recurrence was observed. Therapy with 5-ARIs may represent a potential strategy aimed at reducing BCa recurrence rate, mainly in patients with low stage disease. Further studies are needed to confirm these preliminary data.

scholarly journals Cell-Free Scaffolds in Cartilage Knee Surgery: A Systematic Review and Meta-Analysis of Clinical Evidence

Cartilage ◽  
2019 ◽  
pp. 194760351985240 ◽  
Author(s):  
Luca Andriolo ◽  
Davide Reale ◽  
Alessandro Di Martino ◽  
Angelo Boffa ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Evidence ◽  
Meta Analysis ◽  
Knee Surgery
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