A comparison of balloon angioplasty of native coarctation versus surgical repair for short segment coarctation associated with ventricular septal defect—a single-center retrospective review of 92 cases

A meta-analysis was performed to compare the outcomes between surgery and balloon angioplasty (BA) for native coarctation of the aorta in paediatric patients. Electronic databases, including PubMed, EMbase, Medline and Cochrane Library were searched systematically for literature aimed mainly at comparing the therapeutic effects for native coarctation of the aorta administered by surgery or BA. Corresponding data sets were extracted and 2 reviewers independently assessed the methodological quality. Ten studies meeting the inclusive criteria were identified involving a total of 723 subjects. Eventually, it was observed that compared with BA, surgery was significantly associated with a lower incidence of recoarctation, repeat intervention due to recoarctation and residual transcoarctation gradient in mid- to long-term follow-up. However, BA was significantly associated with a shorter hospitalization time. Incidence of aneurysm formation, perioperative mortality, complications and immediate transcoarctation residual gradient were not statistically different between surgery and BA. The overall level of evidence for our study was low and randomized controlled trials should be designed to evaluate and compare the safety and effectiveness of both approaches for native coarctation of the aorta.

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Surgery versus Balloon angioplasty for treating coarctation of aorta: A meta-analysis

Dani

Thakkar

Desai

et al. 2023

Preprint

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Background: - In the past 50 years, therapeutic options for treating both children and adults with native aortic coarctation have significantly improved. In contrast to surgery, In 1982, balloon angioplasty (BA) was suggested as a potential alternative for the Primary treatment of CoA. Here, Surgery vs Angioplasty is compared to understand the rates of their compilations like aneurysm and recoarctation. Method:- A total of 13 RCTs with a total of 877 patients (Surgery-537, Angioplasty-340) of total patients were identified following PRISMA guidelines till November 2019 and were matched for inclusion and exclusion criteria. The following search strings and MESH terms were used: 'coarctation of aorta', 'surgery', 'balloon angioplasty, and 'aneurysm'. Following this, Surgery and Angioplasty were evaluated for complications and recoarctation. RevMan 5.3 was used for appropriate statistical tests. Fixed and Random Effect Model tests were used and p<0.05 was considered statistically significant. Result: - Angioplasty seems to be a Statistically better alternative with lesser complications (OR=1.993, CI95=1.126 to 3.527, p=0.018). It can be seen that Surgery is statistically far better in preventing the formation of an aneurysm (OR=0.291, CI95=0.141 to 0.602, p=0.001). Surgery as a treatment is statistically better than angioplasty to prevent a recoarctation (OR=0.375, CI95=0.268 to 0.524, p=<0.001). Conclusion: - Surgery is found to be a better treatment option for preventing complications whereas angioplasty is better in preventing the formation of aneurysms and recoarctation. Key words:- Coarctation of Aorta, Surgery, Balloon Angioplasty, Aneurysm

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A comparison of balloon angioplasty of native coarctation versus surgical repair for short segment coarctation associated with ventricular septal defect—a single-center retrospective review of 92 cases

Abstract: The hybrid technique was associated with better periprocedural outcomes for patients with short-segment CoA and VSD. The incidences of aortic re-CoA and re-intervention were comparable between the hybrid technique and surgical groups over a mid-term follow-up.

Cited by 4 publications

References 19 publications

Great Artery and Vascular Anomalies

Great Artery and Vascular Anomalies

Is balloon angioplasty superior to surgery in the treatment of paediatric native coarctation of the aorta: a systematic review and meta-analysis

Surgery versus Balloon angioplasty for treating coarctation of aorta: A meta-analysis

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