Systematic Review And Meta Analysis Of Simple Transannular Patch And Transannular Combined With Single Mitral Valve In The Treatment Of Tetralogy Of Fallot

Objective To evaluate the perioperative efficacy of simple transvalvular patch and transannular combined with single mitral valve in the treatment of tetralogy of Fallot.Methods Chinese periodical full-text database(CNKI),Wanfang database(Wanfang),VIP periodical database(VIP),Pub Med,The Cochrane Library,Web Of Science,Library and Web Of Science were searched by computer.The search time limit is for each database to be built until December 2022.To collect the published literatures about TAP and TAP combined with single mitral valve implantation in the treatment of TOF.The main Chinese and English search words are: tetralogy of Fallot,cross-ring patch,valved pericardial patch,Tetralogy Of Fallot,cusp,monocusp,monocuspid,transannular,pulmonary.Meta analysis was carried out with Rev Man software.Results A total of 12 articles were included,including 2 RCT articles and 10 cohort studies.There were 362 patients in TAP group and 370 patients in TAP with single valve group.The results of Meta analysis showed that compared with the TAP group,the TAP group with single valve had less perioperative mortality [OR=3.2,95%CI(1.20,8.51),P=0.02],shorter postoperative mechanical ventilation time [MD=17.04,95%CI(4.43-29.66),P=0.0008],shorter ICU stay time [MD=26.25,95%CI(0.12-52.38),P=0.05]and less postoperative pleural effusion[OR=4.07,95%CI(1.01-16.5),P=0.05],less postoperative PR [OR=4.12,95%CI(1.18-14.4),P=0.03],longer intraoperative CBP[MD=18.14,95%CI(21.42-14.85),P<0.00001],longer intraoperative aortic clamping time [MD=18.78,95%CI(31.98-5.58),P=0.005],higher postoperative RVOT pressure gradient [MD=2.29,95%CI(3.66-0.92),P=0.001].