Linqi Yang1, Xiuzhen Chua2, Dimple D Rajgor3, Bee Choo Tai4, Swee Chye Quek5. 1. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: linqi_yang@nuhs.edu.sg. 2. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: xiuzhen_chua@nuhs.edu.sg. 3. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: paerdd@nus.edu.sg. 4. Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Electronic address: bee_choo_tai@nuhs.edu.sg. 5. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: swee_chye_quek@nuhs.edu.sg.
Abstract
BACKGROUND/ OBJECTIVES: The treatment of native coarctation of aorta (CoA) has evolved since surgery performed in 1944, followed by transcatheter balloon angioplasty and recently, widely adopted stent implantation. Despite good results demonstrated with stent implantation, a systematic review and meta-analysis (SRMA) looking at the efficacy and safety of the intervention, particularly in younger population is yet to be done. We aimed to obtain pooled estimates of the success and complication rates after transcatheter stent implantation in the treatment of native CoA based on SRMA. METHODS: We searched literature published until 31 Dec. 2015, reporting outcomes of transcatheter stent implantation in the treatment of native CoA. The pooled estimates were obtained using the random effect model. RESULTS: Seventeen reports comprising 561 patients were included. Fourteen studies reported 100% success rate, the lowest was 77%, the largest study reported 81% using a definition of systolic pressure difference of less than 15mmHg. The pooled estimate of overall success rate was 98% (95% CI: 94.5-100.0; I2=65%, heterogeneity test p<0.001). Six out of 17 studies reported zero complication. Two studies, however, reported complications in almost half of the cohort. The pooled estimate of rate of complications was 10% (95% CI: 5.1-15.5; I2=72%, heterogeneity test p<0.001). Three studies comprising only children, 62, with mean age of 11.1 (4-19) years reported high mean success rate at 98% with only 1 failure. CONCLUSIONS: There is a high success rate with a small complication rate with stent implantations for native CoA even as the treatment is brought to younger age group.
BACKGROUND/ OBJECTIVES: The treatment of native coarctation of aorta (CoA) has evolved since surgery performed in 1944, followed by transcatheter balloon angioplasty and recently, widely adopted stent implantation. Despite good results demonstrated with stent implantation, a systematic review and meta-analysis (SRMA) looking at the efficacy and safety of the intervention, particularly in younger population is yet to be done. We aimed to obtain pooled estimates of the success and complication rates after transcatheter stent implantation in the treatment of native CoA based on SRMA. METHODS: We searched literature published until 31 Dec. 2015, reporting outcomes of transcatheter stent implantation in the treatment of native CoA. The pooled estimates were obtained using the random effect model. RESULTS: Seventeen reports comprising 561 patients were included. Fourteen studies reported 100% success rate, the lowest was 77%, the largest study reported 81% using a definition of systolic pressure difference of less than 15mmHg. The pooled estimate of overall success rate was 98% (95% CI: 94.5-100.0; I2=65%, heterogeneity test p<0.001). Six out of 17 studies reported zero complication. Two studies, however, reported complications in almost half of the cohort. The pooled estimate of rate of complications was 10% (95% CI: 5.1-15.5; I2=72%, heterogeneity test p<0.001). Three studies comprising only children, 62, with mean age of 11.1 (4-19) years reported high mean success rate at 98% with only 1 failure. CONCLUSIONS: There is a high success rate with a small complication rate with stent implantations for native CoA even as the treatment is brought to younger age group.
Authors: Joshua D Kurtz; Agustin E Rubio; Troy A Johnston; Brian H Morray; Thomas K Jones Journal: Pediatr Cardiol Date: 2022-03-10 Impact factor: 1.838
Authors: Pradyumna Agasthi; Sai Harika Pujari; Andrew Tseng; Joseph N Graziano; Francois Marcotte; David Majdalany; Farouk Mookadam; Donald J Hagler; Reza Arsanjani Journal: World J Cardiol Date: 2020-05-26