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

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.