Outcomes in Primary Repair of Truncus Arteriosus with Significant Truncal Valve Insufficiency: A Systematic Review and Meta-analysis
Data regarding the effect of significant TVI on outcomes after truncus arteriosus (TA) repair are limited. The aim of this meta-analysis was to summarize outcomes among patients aged ≤ 24 months undergoing TA repair with at least moderate TVI. A systematic literature search was conducted in PubMed,...
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| Veröffentlicht in: | Pediatric cardiology 2023-12, Vol.44 (8), p.1649-1657 |
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| creator | Mitta, Alekhya Vogel, Andrew D. Korte, Jeffrey E. Brennan, Emily Bradley, Scott M. Kavarana, Minoo N. Konrad Rajab, T. Kwon, Jennie H. |
| description | Data regarding the effect of significant TVI on outcomes after truncus arteriosus (TA) repair are limited. The aim of this meta-analysis was to summarize outcomes among patients aged ≤ 24 months undergoing TA repair with at least moderate TVI. A systematic literature search was conducted in PubMed, Scopus, and CINAHL Complete from database inception through June 1, 2022. Studies reporting outcomes of TA repair in patients with moderate or greater TVI were included. Studies reporting outcomes only for patients aged > 24 months were excluded. The primary outcome was overall mortality, and secondary outcomes included early mortality and truncal valve reoperation. Random-effects models were used to estimate pooled effects. Assessment for bias was performed using funnel plots and Egger’s tests. Twenty-two single-center observational studies were included for analysis, representing 1,172 patients. Of these, 232 (19.8%) had moderate or greater TVI. Meta-analysis demonstrated a pooled overall mortality of 28.0% after TA repair among patients with significant TVI with a relative risk of 1.70 (95% CI [1.27–2.28],
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| doi_str_mv | 10.1007/s00246-023-03231-9 |
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p
< 0.001) compared to patients without TVI. Significant TVI was also significantly associated with an increased risk for early mortality (RR 2.04; 95% CI [1.36–3.06],
p
< 0.001) and truncal valve reoperation (RR 3.90; 95% CI [1.40–10.90],
p
= 0.010). Moderate or greater TVI before TA repair is associated with an increased risk for mortality and truncal valve reoperation. Management of TVI in patients remains a challenging clinical problem. Further investigation is needed to assess the risk of concomitant truncal valve surgery with TA repair in this population.</description><identifier>ISSN: 0172-0643</identifier><identifier>EISSN: 1432-1971</identifier><identifier>DOI: 10.1007/s00246-023-03231-9</identifier><identifier>PMID: 37474609</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Analysis ; Cardiac Surgery ; Cardiology ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Mortality ; Review ; Valves ; Vascular Surgery</subject><ispartof>Pediatric cardiology, 2023-12, Vol.44 (8), p.1649-1657</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c365t-e43d1de4a9651afc52686e7b99f3ea8dc389a65522914e2fd59c898fe52ea4bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00246-023-03231-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00246-023-03231-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37474609$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mitta, Alekhya</creatorcontrib><creatorcontrib>Vogel, Andrew D.</creatorcontrib><creatorcontrib>Korte, Jeffrey E.</creatorcontrib><creatorcontrib>Brennan, Emily</creatorcontrib><creatorcontrib>Bradley, Scott M.</creatorcontrib><creatorcontrib>Kavarana, Minoo N.</creatorcontrib><creatorcontrib>Konrad Rajab, T.</creatorcontrib><creatorcontrib>Kwon, Jennie H.</creatorcontrib><title>Outcomes in Primary Repair of Truncus Arteriosus with Significant Truncal Valve Insufficiency: A Systematic Review and Meta-analysis</title><title>Pediatric cardiology</title><addtitle>Pediatr Cardiol</addtitle><addtitle>Pediatr Cardiol</addtitle><description>Data regarding the effect of significant TVI on outcomes after truncus arteriosus (TA) repair are limited. The aim of this meta-analysis was to summarize outcomes among patients aged ≤ 24 months undergoing TA repair with at least moderate TVI. A systematic literature search was conducted in PubMed, Scopus, and CINAHL Complete from database inception through June 1, 2022. Studies reporting outcomes of TA repair in patients with moderate or greater TVI were included. Studies reporting outcomes only for patients aged > 24 months were excluded. The primary outcome was overall mortality, and secondary outcomes included early mortality and truncal valve reoperation. Random-effects models were used to estimate pooled effects. Assessment for bias was performed using funnel plots and Egger’s tests. Twenty-two single-center observational studies were included for analysis, representing 1,172 patients. Of these, 232 (19.8%) had moderate or greater TVI. Meta-analysis demonstrated a pooled overall mortality of 28.0% after TA repair among patients with significant TVI with a relative risk of 1.70 (95% CI [1.27–2.28],
p
< 0.001) compared to patients without TVI. Significant TVI was also significantly associated with an increased risk for early mortality (RR 2.04; 95% CI [1.36–3.06],
p
< 0.001) and truncal valve reoperation (RR 3.90; 95% CI [1.40–10.90],
p
= 0.010). Moderate or greater TVI before TA repair is associated with an increased risk for mortality and truncal valve reoperation. Management of TVI in patients remains a challenging clinical problem. Further investigation is needed to assess the risk of concomitant truncal valve surgery with TA repair in this population.</description><subject>Analysis</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Review</subject><subject>Valves</subject><subject>Vascular Surgery</subject><issn>0172-0643</issn><issn>1432-1971</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kU9rFTEUxYMo9ln9Ai4k4MbNtPk3mcTdo1gttFRsdRvyMjfPlJnMM8m0vH0_uKlTBUHkLnLJ_Z3D5R6EXlNyRAnpjjMhTMiGMN4Qzjht9BO0ooKzhuqOPkUrQjvWECn4AXqR8w0hRBHVPkcHvBOdkESv0P3lXNw0QsYh4s8pjDbt8RfY2ZDw5PF1mqObM16nAilMubZ3oXzHV2Ebgw_OxrIwdsDf7HAL-Czm2ddJgOj27_EaX-1zgdGW4KrvbYA7bGOPL6DYxkY77HPIL9Ezb4cMrx7fQ_T19MP1yafm_PLj2cn6vHFctqUBwXvag7BattR61zKpJHQbrT0Hq3rHlbaybRnTVADzfaud0spDy8CKzYYfoneL7y5NP2bIxYwhOxgGG2Gas2FKUMKIUKSibxd0awcwIfqpJOsecLPupJRCUcEqdfQPqlYPY3BTBB_q_18CtghcmnJO4M1uubmhxDyEapZQTQ3V_ArV6Cp687j2vBmh_yP5nWIF-ALkOopbSOZmmlM9bv6f7U8vv61p</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Mitta, Alekhya</creator><creator>Vogel, Andrew D.</creator><creator>Korte, Jeffrey E.</creator><creator>Brennan, Emily</creator><creator>Bradley, Scott M.</creator><creator>Kavarana, Minoo N.</creator><creator>Konrad Rajab, T.</creator><creator>Kwon, Jennie H.</creator><general>Springer US</general><general>Springer</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20231201</creationdate><title>Outcomes in Primary Repair of Truncus Arteriosus with Significant Truncal Valve Insufficiency: A Systematic Review and Meta-analysis</title><author>Mitta, Alekhya ; Vogel, Andrew D. ; Korte, Jeffrey E. ; Brennan, Emily ; Bradley, Scott M. ; Kavarana, Minoo N. ; Konrad Rajab, T. ; Kwon, Jennie H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-e43d1de4a9651afc52686e7b99f3ea8dc389a65522914e2fd59c898fe52ea4bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analysis</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Review</topic><topic>Valves</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mitta, Alekhya</creatorcontrib><creatorcontrib>Vogel, Andrew D.</creatorcontrib><creatorcontrib>Korte, Jeffrey E.</creatorcontrib><creatorcontrib>Brennan, Emily</creatorcontrib><creatorcontrib>Bradley, Scott M.</creatorcontrib><creatorcontrib>Kavarana, Minoo N.</creatorcontrib><creatorcontrib>Konrad Rajab, T.</creatorcontrib><creatorcontrib>Kwon, Jennie H.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mitta, Alekhya</au><au>Vogel, Andrew D.</au><au>Korte, Jeffrey E.</au><au>Brennan, Emily</au><au>Bradley, Scott M.</au><au>Kavarana, Minoo N.</au><au>Konrad Rajab, T.</au><au>Kwon, Jennie H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes in Primary Repair of Truncus Arteriosus with Significant Truncal Valve Insufficiency: A Systematic Review and Meta-analysis</atitle><jtitle>Pediatric cardiology</jtitle><stitle>Pediatr Cardiol</stitle><addtitle>Pediatr Cardiol</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>44</volume><issue>8</issue><spage>1649</spage><epage>1657</epage><pages>1649-1657</pages><issn>0172-0643</issn><eissn>1432-1971</eissn><abstract>Data regarding the effect of significant TVI on outcomes after truncus arteriosus (TA) repair are limited. The aim of this meta-analysis was to summarize outcomes among patients aged ≤ 24 months undergoing TA repair with at least moderate TVI. A systematic literature search was conducted in PubMed, Scopus, and CINAHL Complete from database inception through June 1, 2022. Studies reporting outcomes of TA repair in patients with moderate or greater TVI were included. Studies reporting outcomes only for patients aged > 24 months were excluded. The primary outcome was overall mortality, and secondary outcomes included early mortality and truncal valve reoperation. Random-effects models were used to estimate pooled effects. Assessment for bias was performed using funnel plots and Egger’s tests. Twenty-two single-center observational studies were included for analysis, representing 1,172 patients. Of these, 232 (19.8%) had moderate or greater TVI. Meta-analysis demonstrated a pooled overall mortality of 28.0% after TA repair among patients with significant TVI with a relative risk of 1.70 (95% CI [1.27–2.28],
p
< 0.001) compared to patients without TVI. Significant TVI was also significantly associated with an increased risk for early mortality (RR 2.04; 95% CI [1.36–3.06],
p
< 0.001) and truncal valve reoperation (RR 3.90; 95% CI [1.40–10.90],
p
= 0.010). Moderate or greater TVI before TA repair is associated with an increased risk for mortality and truncal valve reoperation. Management of TVI in patients remains a challenging clinical problem. Further investigation is needed to assess the risk of concomitant truncal valve surgery with TA repair in this population.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37474609</pmid><doi>10.1007/s00246-023-03231-9</doi><tpages>9</tpages></addata></record> |
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| subjects | Analysis Cardiac Surgery Cardiology Medical research Medicine Medicine & Public Health Medicine, Experimental Mortality Review Valves Vascular Surgery |
| title | Outcomes in Primary Repair of Truncus Arteriosus with Significant Truncal Valve Insufficiency: A Systematic Review and Meta-analysis |
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