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

Dani, A.; Thakkar, H.; Desai, D.; Dani, J. S.; Dani, S. I.

2023-04-07 cardiovascular medicine
10.1101/2023.04.06.23288276 medRxiv
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BackgroundIn 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.

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