Modified Single-Patch versus Two-Patch Repair for Atrioventricular Septal Defect: A Systematic Review and...

Area of Science:

• Cardiology
• Pediatric Surgery
• Medical Technology

Background:

• Atrioventricular septal defects (ASDs) are congenital heart conditions requiring surgical repair.
• The choice of surgical technique, specifically single-patch versus two-patch repair, is a subject of ongoing clinical evaluation.
• Postoperative outcomes following ASD repair are critical for patient recovery and long-term health.

Purpose of the Study:

• To conduct a meta-analysis comparing the modified single-patch repair technique with the traditional two-patch repair for ASDs.
• To evaluate the impact of the modified single-patch technique on various postoperative outcomes.

Main Methods:

• A systematic review identified studies comparing modified single-patch and two-patch ASD repair techniques.
• Meta-analysis using fixed-effects and random-effects models was performed based on heterogeneity.
• Meta-regression was employed to assess the influence of other factors on outcomes.

Main Results:

• Ten studies involving 724 patients were included in the meta-analysis.
• The modified single-patch repair was associated with significantly reduced cardiopulmonary bypass time (mean difference -28.53 minutes) and cross-clamp time (mean difference -22.69 minutes).
• No significant differences were observed in mechanical ventilation duration, ICU/hospital length of stay, reoperation rates, or mortality between the two techniques.

Conclusions:

• The modified single-patch repair technique for atrioventricular septal defects offers a significant advantage by reducing cardiopulmonary bypass and cross-clamp times.
• Despite the reduction in procedural times, the modified single-patch repair did not demonstrate statistically significant improvements in other key postoperative outcomes when compared to the two-patch repair.