A Systematic Review and Meta-Analysis of the Valvular Insufficiency Status after Surgical Closure of Ventricular Septal Defects

作者：Li Lai, Minghui Zhang, Aijun Liu, Junwu Su · 发表于：The Heart Surgery Forum · 年份：2025 · DOI：10.59958/hsf.8771 · 研究领域：Cardiac Valve Diseases and Treatments、Congenital Heart Disease Studies、Aortic Disease and Treatment Approaches

Objective: This article aims to provide a reference for assessing surgical safety by comparing postoperative outcomes of various degrees of valve insufficiency associated with different surgical approaches after ventricular septal defect (VSD) repair. Methods: We conducted a database search using the following methods: querying the PubMed database through National Center for Biotechnology Information (NCBI), querying the Embase database through Ovid, and querying the Web of Science database. This article focused on comparing the improvement in aortic regurgitation (AR), analyzing the incidence of tricuspid regurgitation (TR) following exposure of the VSD through a right atrial approach using tricuspid valve detachment (TVD) or conventional exposure (non-TVD), and pulmonary regurgitation (PR) via a pulmonary artery approach. Results: AR was included in nine studies, involving 329 children with VSDs. The combined improvement rate of AR across these studies was approximately 0.487 (I2 = 50.3%; p = 0.041). The proportion of patients who underwent aortic valve repair or replacement (p = 0.029) and the preoperative severity of AR ≥ moderate (p = 0.007) may have contributed to heterogeneity. There were 245 cases in the isolated VSD repair group, while the remaining 84 cases underwent combined aortic valve repair or replacement. There was a significant difference in the improvement rate of AR between the two groups during follow-up (I2 = 63.3%, Relative Risk (RR) = 0.51, 95% CI = 0.3...