# Midterm Results Comparing Perventricular Device Closure with Surgical Repair for Isolated Congenital Ventricular Septal Defects: A Systematic Review and Meta-Analysis

## TL;DR

This study compares two treatments for heart defects and finds that both are safe, but one has a higher success rate while the other causes less surgical injury.

## Contribution

A systematic review and meta-analysis comparing midterm outcomes of PDC and CSR for VSD.

## Key findings

- CSR had a higher success rate compared to PDC.
- PDC had a lower risk of aortic regurgitation compared to CSR.
- PDC resulted in less surgical injury and shorter hospital stays.

## Abstract

This systematic review and meta-analysis aimed at comparing
the midterm outcomes of perventricular device closure (PDC) with conventional
surgical repair (CSR) for VSD.

PubMed, Cochrane Library, and
Web of Science databases were searched from January 1, 2005, to October 15, 2020,
for English or Chinese language studies comparing outcomes of PDC with CSR for
VSD. The midterm results were assessed as a primary outcome. A systematic review
and meta-analysis was performed under the frequentist frame with risk ratio (RR)
and 95% confidence interval (CI).

A total of 4381 patients
(PDC = 2016, CSR = 2365) from 15 studies were included. The pooled estimates of
success rate favored the CSR compared with the PDC (RR, 0.97; 95% CI, 0.96 to
0.99; p = 0.001). No significant differences in minor complications or
severe complications were found between the PDC and CSR (RR, 0.79; 95% CI, 0.50
to 1.23; p = 0.29; RR, 1.43; 95% CI, 0.74 to 2.75; p = 0.29).
The pooled estimates of residual shunts favored the PDC compared with the CSR
(RR, 9.07; 95% CI, 4.77 to 17.24; p < 0.001), the pooled estimates of
aortic regurgitation favored the CSR compared with the PDC (RR, 1.59; 95% CI,
1.05 to 2.39; p = 0.03).

PDC is a safe and
effective procedure with less surgical injury and shorter perioperative hospital
stay. However, aortic regurgitation is a concern during follow-up.