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<p>To compare clinical outcomes of ductal stenting (DS) with modified Blalock–Taussig–Thomas shunt (BTS) as initial palliation of neonates with duct-dependent pulmonary blood flow (PBF) lesions. This systematic review and meta-analysis was designed and carried out in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for reporting. The trial strategy was registered in PROSPERO (CRD420251034196). Eleven studies had a total of 1348 patients, divided between 533 in the DS group and 815 in the BTS group. The DS group showed significantly lower early and overall mortality rate compared to the BTS group [[5.3% in the DS group versus 8.9% in the BTS group, OR 0.51 (0.28, 0.93) 95% CI, <i>P</i> = 0.03] and [7.6% in DS group versus 14.4% in BTS group, OR 0.50 (0.33, 0.76) 95% CI, <i>P</i> = 0.001], respectively. The DS group also had a significantly lower post-procedure complications rate [16.1% in the DS group versus 21.3% in the BTS group, OR 0.50 (0.35, 0.69) 95% CI, <i>P</i> = 0.0001]. Additionally, the DS group was superior in terms of post-procedure oxygen saturation [MD 1.89 (1.52, 2.27) 95% CI, <i>P</i> = 0.00001] and hospital and Intensive care unit (ICU) length of stay (LOS) [MD −&#xa0;6.69 (−&#xa0;9.09, −&#xa0;4.28) 95% CI, <i>P</i> = 0.00001], [MD −&#xa0;4.80 (−&#xa0;6.01, −&#xa0;3.18), <i>P</i> = 0.00001]. There was no significant difference between the two groups regarding early and late interventions, the need for extra-corporeal membrane oxygenation (ECMO) and post-procedure pulmonary artery (PA) growth and symmetry. DS is associated with a significant reduction in both early and late mortalities, shorter hospital and ICU LOS and fewer procedural complications compared to the BTS group. There is higher rate of late re-interventions in the DS group but no significant difference in need for ECMO or PA growth between the two groups.</p>

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Ductal Stenting Versus Aorto-Pulmonary Shunt for Lesions with Duct-Dependent Pulmonary Blood Flow: A Systematic Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • Huzeifa Elhedai,
  • Ali Yasen Mohamedahmed,
  • Setelbanat Mohamed,
  • Salma Saeed Mohammed,
  • Suhair Shebani,
  • Frances Bu’Lock,
  • Marinos Kantzis

摘要

To compare clinical outcomes of ductal stenting (DS) with modified Blalock–Taussig–Thomas shunt (BTS) as initial palliation of neonates with duct-dependent pulmonary blood flow (PBF) lesions. This systematic review and meta-analysis was designed and carried out in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for reporting. The trial strategy was registered in PROSPERO (CRD420251034196). Eleven studies had a total of 1348 patients, divided between 533 in the DS group and 815 in the BTS group. The DS group showed significantly lower early and overall mortality rate compared to the BTS group [[5.3% in the DS group versus 8.9% in the BTS group, OR 0.51 (0.28, 0.93) 95% CI, P = 0.03] and [7.6% in DS group versus 14.4% in BTS group, OR 0.50 (0.33, 0.76) 95% CI, P = 0.001], respectively. The DS group also had a significantly lower post-procedure complications rate [16.1% in the DS group versus 21.3% in the BTS group, OR 0.50 (0.35, 0.69) 95% CI, P = 0.0001]. Additionally, the DS group was superior in terms of post-procedure oxygen saturation [MD 1.89 (1.52, 2.27) 95% CI, P = 0.00001] and hospital and Intensive care unit (ICU) length of stay (LOS) [MD − 6.69 (− 9.09, − 4.28) 95% CI, P = 0.00001], [MD − 4.80 (− 6.01, − 3.18), P = 0.00001]. There was no significant difference between the two groups regarding early and late interventions, the need for extra-corporeal membrane oxygenation (ECMO) and post-procedure pulmonary artery (PA) growth and symmetry. DS is associated with a significant reduction in both early and late mortalities, shorter hospital and ICU LOS and fewer procedural complications compared to the BTS group. There is higher rate of late re-interventions in the DS group but no significant difference in need for ECMO or PA growth between the two groups.