title: Catheterization therapy vs surgical closure in pediatric patients with patent ductus arteriosus: a meta-analysis.
abstract: BACKGROUND
  Patent ductus arteriosus (PDA) remains a common congenital heart disease in pediatric patients, and the new trend of catheterization therapy is still associated with some potential risks and complications.
  
  
  OBJECTIVE
  Compared with surgical closure, the clinical effect of catheterization therapy in pediatric PDA patients requires meta-analysis.
  
  
  METHODS
  A systematic literature search of PubMed, Cochrane Library, Embase, Science Citation Index, Web of Science, and the Chinese Biomedicine literature database was conducted. Eligible studies included controlled trials of pediatric PDA patients receiving catheterization therapy vs surgical closure. Relative risks (RRs), standard mean differences, and 95% confidence intervals (CIs) were calculated and heterogeneity was assessed with the I(2) test.
  
  
  RESULTS
  Seven studies with a total of 810 patients met the inclusion criteria. Catheterization therapy neither significantly increased the primary success rate (RR: 0.92, 95% CI: 0.82-1.03, P = 0.16) nor reduced the total postprocedure complications (RR: 0.74, 95% CI: 0.44-1.25, P = 0.26) and blood transfusion (RR: 1.10, 95% CI: 0.16-7.67, P = 0.93). Catheterization was associated with a statistically significant increase in residual shunts (RR: 5.19, 95% CI: 1.41-19.20, P = 0.01) and reduction in length of hospital stay (standard mean difference: -1.66, 95% CI: -2.65 to -0.67, P = 0.001).
  
  
  CONCLUSIONS
  Catheterization therapy in pediatric PDA patients did not show a significant advantage in primary success rate, total complications, or blood transfusion, but it was associated with increase in residual shunts and reduction in length of hospital stay.
authors.affiliation: Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.forename: Xuanren
authors.initials: X
authors.lastname: Pan
authors.forename: Qiaoyun
authors.initials: Q
authors.lastname: Tang
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Pang
mesh_terms: D001803:Blood Transfusion; D006328:Cardiac Catheterization; D002648:Child; D004374:Ductus Arteriosus, Patent / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications; D055989:Septal Occluder Device