UPDATES ON SURGICAL MANAGEMENT OF COARCTATION OF AORTA: A SYSTEMATIC REVIEW

RESUMO

Malik Azhar Hussain*, Najd Turki M Alanazi, Jawaher Awad A Alshammari, Taif Khalaf K Alanazi, Amwaj Nawaf I Alshammari

Background: Aortic coarctation (CoA) is a congenital deformity that frequently coexists with other cardiac disorders. The operation's results are currently satisfactory, but postoperative restenosis is still a concern. Patient results might be enhanced by early therapy changes and the identification of restenosis risk factors. Objectives: This systematic review aims to study the recent updates regarding the surgical approach to CoA.

Methods: PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. Rayyan QRCI was employed throughout this comprehensive process.

Results & interpretation: Our results included nine studies with a total of 708 patients, and 466 (56.9%) were males. Preoperative diagnostic accuracy was greatly improved when CTA (CT angiography) and TTE (transthoracic echocardiography) The reported surgical approaches such as resection with end-to-end anastomosis (EEA), extended resection with end-to-end anastomosis (EEEA), subclavian flap aortoplasty (SCAP), patch aortoplasty (PP), and Interposition graft (IPG) were all found safe and successful for CoA repair. Even when comparing these first two methods, no differences in mortality or re-coarctation were found. It was discovered that aortoplasty was a better defence against re-coarcitation. The degree of CoA was a highly significant predictor of poor surgical outcomes.