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257407

Outcome of Surgical Repair of Coarctation in the Neonate: Meta-Analysis

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Last updated: 22 Jan 2023

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Abstract

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.

DOI

10.21608/mjcu.2022.257407

Keywords

Surgical repair, Coarctation in neonate

Authors

First Name

HASSAN M.A. MOFTAH, M.D.;

Last Name

ASHRAF A. ELMIDANY, M.D.

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First Name

MOHAMED A. ABD ELFATTAH, M.D.;

Last Name

MOSTAFA R. HESSAIN, M.Sc.

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Affiliation

The Department of Cardiothoracic Surgery, Faculty of Medicine, Ain Shams University

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Volume

90

Article Issue

6

Related Issue

36019

Issue Date

2022-06-01

Receive Date

2022-09-01

Publish Date

2022-06-01

Page Start

1,163

Page End

1,177

Print ISSN

0045-3803

Online ISSN

2536-9806

Link

https://mjcu.journals.ekb.eg/article_257407.html

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https://mjcu.journals.ekb.eg/service?article_code=257407

Order

257,407

Type

Original Article

Type Code

263

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

Publication Link

https://mjcu.journals.ekb.eg/

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Article

Created At

22 Jan 2023