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

Author:

Dani Avichal,Thakkar Helly,Desai DevORCID,Dani Jagdeepkaur S.,Dani Sameer I.

Abstract

AbstractBackgroundIn 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.MethodA 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.ResultAngioplasty 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).ConclusionSurgery is found to be a better treatment option for preventing complications whereas angioplasty is better in preventing the formation of aneurysms and recoarctation.

Publisher

Cold Spring Harbor Laboratory

Reference13 articles.

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2. Thomas J . Forbes DWK , Wei Du , Daniel R . Turner Ralf Holzer , Zahid Amin , Ziyad Hijazi , Abdolrahim Ghasemi , Jonathan J. Rome , David Nykanen , Evan Zahn , Collin Cowley , Mark Hoyer , David Waight , Daniel Gruenstein , Alex Javois , Susan Foerster , Jacqueline Kreutzer , Nancy Sullivan , Asra Khan , Carl Owada , Donald Hagler , Scott Lim , Joshua Canter , Thomas Zellers ,. Comparison of Surgical, Stent, and Balloon Angioplasty Treatment of Native Coarctation of the Aorta: An Observational Study by the CCISC (Congenital Cardiovascular Interventional Study Consortium) 2011 [Available from: https://www.jacc.org/doi/abs/10.1016/j.jacc.2011.08.053

3. P. Syamasundar Rao PSC , Rebecca Koscik , Patricia A. Smith , Allen D. Wilson ,. Surgical versus balloon therapy for aortic coarctation in infants ≤ 3 months old 1994 [Available from: https://www.jacc.org/doi/abs/10.1016/0735-1097(94)90395-6

4. Huifeng Zhang MY , Gang Chen , Fang Liu , Lin Wu , Bing Jia . 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 2016 [Available from: https://pubmed.ncbi.nlm.nih.gov/27621858/.

5. R E Shaddy MMB , J E Sturtevant , H D Ruttenberg , R B Jaffe , L Y Tani , V E Judd , L G Veasy , E C McGough and G S Orsmond . Comparison of angioplasty and surgery for unoperated coarctation of the aorta. 1993 [Available from: https://www.ahajournals.org/doi/abs/10.1161/01.cir.87.3.793

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