Evidence map›Paper›PMID 34544460›Full record

SynthesisJournal of cardiothoracic surgery2021

Anterolateral minithoracotomy versus median sternotomy for the surgical treatment of atrial septal defects: a meta-analysis and systematic review.

Yu-Qing Lei, Jian-Feng Liu, Wen-Peng Xie, Zhi-Nuan Hong, Qiang Chen, Hua Cao

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of cardiothoracic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Minimal-Access Atrial Septal Defect (ASD) Closure.Journal of cardiovascular development and disease · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yu-Qing Lei *Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.
Jian-Feng Liu *Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.
Wen-Peng Xie *Department of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.
Zhi-Nuan HongFujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Qiang ChenDepartment of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China. chenqiang2228@163.com.
Hua CaoDepartment of Cardiac Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China. caohua0791@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo compare the short-term safety and efficacy of right anterolateral minithoracotomy (ALMT) and median sternotomy (MS) for the surgical treatment of atrial septal defects (ASDs).

methodsThe PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for comparative studies focusing on surgical repair of ASDs via ALMT or MS published up to the end of April 27, 2020. We used random-effect or fixed-effect models to obtain pooled estimates.

resultsA total of 7 publications, including 665 patients (ALMT 296 and MS 369), were included. Age (WMD: 1.80 years, 95% CI 0.31-3.29), weight (WMD: - 0.91 kg, 95% CI - 5.57 to 3.75), sex distribution (OR: 1.00, 95% CI 0.74-1.35) and surgical type (patch or direct closure) (OR: 1.00, 95% CI 0.67-1.49) were comparable in the ALMT group and MS group. No significant differences in the success rate (OR 0.23; 95% CI 0.05-1.07) or severe complication rate (OR 1.46; 95% CI 0.41-5.22) were found between the ALMT group and the MS group. In addition, the differences in the cardiopulmonary bypass (CPB) time (WMD 6.33; 95% CI - 1.92 to 14.58 min, p = 0.13) and the operation time (WMD 5.23; 95% CI - 12.49 to 22.96 min, p = 0.56) between the ALMT group and the MS group were not statistically significant. However, the ALMT group had a significantly longer aortic cross-clamp time (2.37 min more, 95% CI 1.07-3.67 min, p = 0.0003). The intubation time was 1.82 h shorter (95% CI - 3.10 to - 0.55 h; p = 0.005), the intensive care unit (ICU) stay was 0.24 days shorter (95% CI - 0.44 to - 0.04 days; p = 0.02), and the postoperative hospital stay was 2.45 days shorter (95% CI - 3.01 to - 1.88 days; p < 0.00001) in the ALMT group than in the MS group. Furthermore, the incision length was significantly shortened by 8.97 cm in the ALMT group compared with the MS group (95% CI - 9.36 to - 8.58 cm; p < 0.00001).

conclusionsIn the surgical treatment of ASD, ALMT and MS are equally safe and effective in terms of success rates and severe complication rates. The surgical procedures are equally difficult, but ALMT is associated with a faster functional recovery and better cosmetic results. Compared to MS, ALMT is the better choice for select ASD patients.

Indexed as

Heart Septal Defects, AtrialSternotomyHumansInfant, NewbornLength of StayMinimally Invasive Surgical ProceduresThoracotomyTreatment OutcomeAnterolateral minithoracotomyAtrial septal defectsMedian sternotomyMeta-analysisSurgery

Identifiers

PMID34544460
PMCPMC8451725

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.