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<p>Early palliation of duct dependent pulmonary circulation aims to secure adequate pulmonary blood flow before definitive repair. Two common strategies are transcatheter ductal stenting and the surgical modified Blalock Taussig shunt. Whether these approaches differ in pulmonary artery growth and branch symmetry remains uncertain. This meta-analysis compared pulmonary artery growth and symmetry after ductal stenting versus modified Blalock Taussig shunt in duct dependent pulmonary blood flow.&#xa0;Five electronic databases (PubMed, Scopus, Cochrane, ScienceDirect and Google Scholar) were searched up to December 2025. Comparative studies reporting quantitative pulmonary artery growth or symmetry (Nakata index, McGoon ratio, and pulmonary artery symmetry index [PASI]) were pooled using random effects meta-analysis and expressed as mean difference (MD) with 95% confidence intervals (CI). Heterogeneity was assessed using I2 and study quality using the Newcastle Ottawa Scale.&#xa0;Nine studies involving 1,460 patients met inclusion criteria. Ductal stenting was associated with a lower PASI (MD -0.16; 95% CI -0.26 to -0.05; p = 0.003; I<sup>2</sup> = 94%), suggesting more symmetric branch pulmonary artery development. Pulmonary artery growth assessed by the Nakata index (MD 24.08; 95% CI -17.98 to 66.14; p = 0.26; I<sup>2</sup> = 98%) and McGoon ratio (MD-0.02; 95% CI -0.44 to 0.39; p = 0.92; I<sup>2</sup> = 90%) did not differ significantly between groups.&#xa0;Ductal stenting was associated with modestly improved pulmonary artery symmetry and similar global pulmonary artery growth compared with the modified Blalock Taussig shunt. Interpretation is limited by high heterogeneity and observational study design. Prospective multicenter studies are needed to clarify patient selection and long term outcomes.</p>

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Pulmonary Artery Growth Among Duct-Dependent Physiology After Ductal Stenting Compared to Modified Blalock–Taussig Shunt: Insights from a Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Hamzah Pratama Megantara,
  • Jesiana Rayvita Utami,
  • Cut Yura Addina

摘要

Early palliation of duct dependent pulmonary circulation aims to secure adequate pulmonary blood flow before definitive repair. Two common strategies are transcatheter ductal stenting and the surgical modified Blalock Taussig shunt. Whether these approaches differ in pulmonary artery growth and branch symmetry remains uncertain. This meta-analysis compared pulmonary artery growth and symmetry after ductal stenting versus modified Blalock Taussig shunt in duct dependent pulmonary blood flow. Five electronic databases (PubMed, Scopus, Cochrane, ScienceDirect and Google Scholar) were searched up to December 2025. Comparative studies reporting quantitative pulmonary artery growth or symmetry (Nakata index, McGoon ratio, and pulmonary artery symmetry index [PASI]) were pooled using random effects meta-analysis and expressed as mean difference (MD) with 95% confidence intervals (CI). Heterogeneity was assessed using I2 and study quality using the Newcastle Ottawa Scale. Nine studies involving 1,460 patients met inclusion criteria. Ductal stenting was associated with a lower PASI (MD -0.16; 95% CI -0.26 to -0.05; p = 0.003; I2 = 94%), suggesting more symmetric branch pulmonary artery development. Pulmonary artery growth assessed by the Nakata index (MD 24.08; 95% CI -17.98 to 66.14; p = 0.26; I2 = 98%) and McGoon ratio (MD-0.02; 95% CI -0.44 to 0.39; p = 0.92; I2 = 90%) did not differ significantly between groups. Ductal stenting was associated with modestly improved pulmonary artery symmetry and similar global pulmonary artery growth compared with the modified Blalock Taussig shunt. Interpretation is limited by high heterogeneity and observational study design. Prospective multicenter studies are needed to clarify patient selection and long term outcomes.