Outcome of Surgical Repair of Coarctation in the Neonate: Meta-Analysis
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- Category: Vol. 90, June 2022
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Outcome of Surgical Repair of Coarctation in the Neonate: Meta-Analysis, HASSAN M.A. MOFTAH, ASHRAF A. ELMIDANY, MOHAMED A. ABD ELFATTAH and MOSTAFA R. HESSAIN
Abstract
Background: Coarctation of aorta (CoA) can be simply defined as cardiac abnormality resulting in obstruction to the blood flow in the aorta. Coarctation of the aorta is the fifths most common congenital heart defect, accounting for 5 to 9%, In neonates who are stabilized within 24h of presentation, surgical repair can be carried outurgently. Aim of Study: Aim of study to analyze outcome of surgical repair of coarctation in neonate. Patients and Methods: The meta-analysis included retro-spective, prospective, randomized, or non-randomized con-trolled trials that study the of outcome of coarctation surgical repair in neonate. Outcome measure include Mortality, need of other surgical intervention (recoarctation or repair of aortic aneurysm or dissection), morbidity include (chylothorax, spinal cord injury, hypertension, and bleeding), and pressure gradient after surgical repair. Results: The results of the meta-analysis for incidence of aneurysm formation was in conclusive due to fluctuating results in the sensitivity analysis. Also our analysis revealed that extendedarchaor to plasty in association with ductal and coarctation excision provides excellent coarctation repair with a low incidence of recoarctation. According to the regression modeling of mortality and the regression modeling of re-intervention demonstrated different significant predictors. Among these predictors, the associated anomalies (hypoplastic aortic arch) demonstrated the greatest impact on both mortality and reintervention in surgical repair of coarctation in neonate. Conclusion: In conclusion, surgical repair of coarctation was significantly associated with a lower incidence of re-CoA, fewer repeat interventions due to re-CoA and lower residual transcoarctation gradient in the mid to long term follow-up.