Risk Factors for Recoarctation and Mortality in Infants Submitted to Aortic Coarctation Repair: A Systematic Review

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Dias, MQ (Author) Other; Barros, A (Author) FMUP; Leite-Moreira AF (Author) FMUP; Joana Miranda (Author) FMUP

Journal

Title: Pediatric Cardiology

Vol. 41

Pages: 561-575

ISSN: 0172-0643

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 15 Citations

Scopus - 28 Citations

Other information

Authenticus ID: P-00R-VMS

DOI: 10.1007/s00246-020-02319-w

Abstract (EN): Aortic coarctation is a common congenital heart defect that often requires correction at a young age. Currently, success is defined by the achievement of a durable repair with low morbidity and mortality. We sought to systematically review the literature on risk factors for recoarctation and mortality in infants submitted to aortic arch coarctation repair under 1 year of age. PubMed and Scopus were searched for studies reporting risk factors for recoarctation and mortality from January 1989 to August 2019. Among the 1038 retrieved articles, 18 met the inclusion criteria, with a total of 2891 patients. The extracted risk factors for recoarctation were comprehensively summarized in the following categories: demographic variables, associated anomalies, clinical and repair variables, and morphometric variables. Younger age and lower weight were weak determinants of need for reintervention, while smaller aortic arch was a strong predictor of recoarctation. While balloon angioplasty is a clear risk factor for arch restenosis, the chosen surgical technique is not a strong risk factor. Associated minor cardiac anomalies and lower weight at surgery were important risk factors for death. Younger and smaller infants are at increased risk for adverse outcomes when submitted to aortic arch coarctation repair. This is particularly important when associated with smaller arch morphology. Strategies to improve the management of these patients may play a key role in improving their outcomes. Notably, surgical technique was not a strong predictor of recoarctation and mortality, suggesting that the choice of one over the other should be tailored.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 15