Open Access

ARTICLE

Comparison of extracardiac conduit and lateral tunnel for functional single-ventricle patients: A meta-analysis

Zhiyong Lin, Hanwei Ge, Jiyang Xue, Guowei Wu, Jie Du, Xingti Hu, Qifeng Zhao

The Children’s Department of Cardiovascular and Thoracic Surgery, Children’s Heart Center, the Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, Wenzhou, P.R. China

* Corresponding Author: Qifeng Zhao, The Children’s Department of Cardiovascular and Thoracic Surgery, Children’s Heart Center, the Second Affiliated Hospital & Yuying Children’s Hospital, Institute of Cardiovascular Development and Translational Medicine, Wenzhou Medical University, No. 109 College West Road, Lucheng District, Wenzhou, 325027, P.R. China. Email:

Congenital Heart Disease 2017, 12(6), 711-720. https://doi.org/10.1111/chd.12503

Abstract

Objective: This study aims to assess and compare the early and long-term effects of extracardiac conduit (EC) and lateral tunnel (LT) in patients with a functional single ventricle through metaanalysis.
Design: A systematic search was performed in PubMed, Embase, Cochrane Library, CNKI, VIP, CBM, and WanFang databases for papers that were published until August 1, 2016. Cochrane systematic review method was used for paper screening and information retrieve, and RevMan 5.3 software was applied for the meta-analysis.
Results: Data for 10 studies with a total of 3814 patients were retrieved. The advantages of EC comparing to LT include: lower 30 day postsurgery supraventricular arrhythmia incidence (Relative Risk [RR] = 0.31 [0.17, 0.55], P < .001), lower protein loss enteropathy incidence (RR = 0.33 [0.11, 0.96], P = .04), and requiring no cardiopulmonary bypass. However, the chest drainage time was longer (mean difference [MD] = 1.99 [1.83, 2.15], P < .001) in EC. There were no significant differences in early postoperative mortality, long-term mortality, long-term arrhythmia, Fontan takedown, ventilator-assisted ventilation, ICU stay, thrombosis, pleural effusion, and pericardial effusion between EC and LT.
Conclusions: EC had a lower incidence of supraventricular arrhythmia (30 days after operation) and the rate of protein losing enteropathy than LT, and requiring no cardiopulmonary bypass. These show that EC has an advantage over the LT in patients with a functional single ventricle.

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