Clinical Outcome of Right Ventricular Outflow Tract Stenting Versus Blalock-Taussig Shunt in Tetralogy of Fallot: A systematic Review and Meta-Analysis

Curr Probl Cardiol. 2021 Mar;46(3):100643. doi: 10.1016/j.cpcardiol.2020.100643. Epub 2020 Jun 4.

Abstract

Aim: Several studies assessed the effectiveness of different therapeutic procedures for repairing right ventricular outflow tract (RVOT) in tetralogy of Fallot (TOF) patients reporting contradictory results. What has been systematically summarized in the present study was to assess the outcome of RVOT stenting in TOF patients and also to compare its outcome with Blalock-Taussig (BT) shunt procedure.

Methods and results: This study was performed according to established methods and in compliance with Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. Two investigators searched the manuscript databases including Medline, Web of knowledge, Google scholar, Scopus, and Cochrane Central Register of Controlled Trials in the Cochrane Library for all eligible studies in accordance with the considered keywords. In final, 10 articles were eligible for the final analysis. The pooled success rate of RVOT stenting was found to be 93.6% (95% confidence interval [CI]: 89.6% to 96.2%). The overall improvement in arterial oxygen saturation following RVOT stenting was also shown to be 20.1%% (95% CI: 15.8% to 25.3%). The procedural-related death was also 3.7% (95% CI: 1.9% to 7.3%). The assessment of the outcome of RVOT stenting and BT shunt showed no significant difference in improvement rate of arterial O2 saturation (Odds ratio = 1.419, 95% CI: 0.645 to 3.123, P= 0.384) and death rate (risk ratios = 0.341, 95% CI: 0.057 to 2.024, P= 0.236).

Conclusion: RVOT stenting leads to appropriate clinical outcome in children suffering TOF Comparing RVOT stenting and BT shunt shows comparable results with respect to clinical sequels. Classifications: Right Ventricular Outflow Tract (RVOT), Tetralogy Of Fallot (TOF), BT shunt.

Condensed abstract: Aim: Present study was to assess the outcome of right ventricular outflow tract (RVOT) stenting in tetralogy of Fallot (TOF) patients and also to compare its outcome with Blalock-Taussig (BT) shunt procedure.

Methods and results: This study was performed according to established methods and in compliance with Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. In final, 10 articles were eligible for the final analysis. The assessment of the outcome of RVOT stenting and BT shunt showed no significant difference in improvement rate of arterial O2 saturation and death rate.

Conclusion: RVOT stenting leads to appropriate clinical outcome in children suffering TOF Comparing RVOT stenting and BT shunt shows comparable results with respect to clinical sequels.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Blalock-Taussig Procedure*
  • Heart Ventricles / surgery
  • Humans
  • Pulmonary Artery / surgery
  • Randomized Controlled Trials as Topic
  • Tetralogy of Fallot* / surgery
  • Treatment Outcome
  • Ventricular Dysfunction, Right / surgery