SynthesisFrontiers in cardiovascular medicine2025
Systematic review and network meta-analysis of outcomes of transcatheter strategies and surgical shunts for treatment of duct-dependent cyanotic congenital heart disease.
Synthesis in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Ductal Stenting in Double Aortic Arch with Tetralogy of Fallot and Pulmonary Atresia: Challenges and Imaging Aspects.Heart views : the official journal of the Gulf Heart AssociationArticle
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Cyanotic congenital heart disease with duct-dependent pulmonary blood flow requires initial palliation before definitive repair. Traditionally, these were surgical systemic-to-pulmonary shunts (SPS) such as the modified Blalock-Taussig-Thomas shunt. Transcatheter procedures are recently emerging as alternative options. Previous reviews have compared ductal stenting (DS) or right ventricular outflow tract (RVOT) intervention to surgical SPS, but none compared all three strategies in a single meta-analysis. Methods: We performed a systematic review and network meta-analysis for a three-way comparison of DS, RVOT intervention, and surgical SPS as initial palliation in children aged 0-3 with cyanotic congenital heart disease. Primary outcomes were mortality rates, complication rates, and re-intervention rates. MEDLINE, EMBASE, and Cochrane databases were searched for publications from 2003 to 2023. References of previous systematic reviews were screened. Results: Twenty publications were included for analysis, for a total of 4,441 patients. Transcatheter options consistently ranked superior to surgical SPS for Early and Overall Mortality. DS also outperformed surgical SPS for Procedural Complications. Surgical SPS was worst for Early Re-interventions, but outperforms both transcatheter options for Overall Re-interventions and Intra-procedural Mortality. Both DS and RVOT stenting conferred a shorter overall hospitalization duration compared to surgical SPS, and DS also gave a shorter length of stay in intensive care compared to surgical SPS. Conclusions: Transcatheter options are viable, safe, and attractive alternatives to traditional surgical shunts in the treatment of duct-dependent cyanotic heart disease. With wider adoption, increased collective expertise will help to further improve patient outcomes of these less-invasive techniques. Systematic Review Registration: PROSPERO (CRD42024489748).
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