الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
I
N conclusion, Surgical repair of coarctation was significantly associated with a lower incidence of re-CoA, fewer repeat interventions due to re-CoA and lower residual transcoarctation gradient in the mid to long term follow up.
However, the results of the meta-analysis for incidence of aneurysm formation was inconclusive due to fluctuating results in the sensitivity analysis.
Also our analysis revealed that extended arch aortoplasty in association with ductal and coarctation excision provides excellent coarctation repair with a low incidence of recoarctation.
According to the regression modeling of mortality and the regression modeling of re-intervention demonstrated different significant predictors. Among these predictors, the associated anomalies (hypoplastic aortic arch) demonstrated the greatest impact on both mortality and reintervention in surgical repair of coarctation in neonate.
LIMITATIONS
A
lthough we have attempted to overcome all the short comings of previous meta-analyses and updated the latest relevant literature, there were still a few limitations in our study.
First, this study based on meta-analysis and required more recent RCT with large sample size
Secondly, common baseline data significantly affecting clinical outcomes such as age, weight, gender, preoperative gradient and associated anomalies were not statistically different across most of the NRCTs.
Therefore, we believe the results of our meta-analysis are trustworthy, although the selection bias of the included NRCTs did lack matched pairs and propensity score matching. Finally, we initially planned to include studies comparing surgery versus stent implantation which was regarded as a more modern approach, Stent implantation was reported to lower risk of potential aneurysm formation.
SUMMARY
C
oarctation of aorta (CoA) can be simply defined as cardiac abnormality resulting in obstruction to the blood flow in the aorta. CoA can occur at any region in the thoracic and abdominal aorta. Most common location for CoA is just distal to the left subclavian artery at the point where ductus arteriosus connects to the aorta. Typically there is presence of medial thickening with “shelf like” tissue protruding in the lumen of aorta from the posterior aortic wall.
Aim of study to evaluate outcome of surgical repair of coarctation in neonate.
The review included retrospective, prospective, randomized, or non-randomized controlled trials that study the of outcome of coarctation surgical repair in neonate.
Types of participants: Neonate with Coarctation surgical repair.
Types of interventions: Coarctation surgical repair
In our analysis surgical repair of coarctation was significantly associated with a lower incidence of re-CoA, fewer repeat interventions due to re-CoA and lower residual transcoarctation gradient in the mid to long term follow up.
However, the results of the meta-analysis for incidence of aneurysm formation was in conclusive due to fluctuating results in the sensitivity analysis.
Our meta analysis showed Pooling of the effect sizes of different demographic predictors as body surface area at surgery, associated anomalies, and repair variables from the different studies reporting the regression modeling of mortality data demonstrated different significant predictors. Among these predictors, the associated anomalies demonstrated the greatest impact (OR=3.65; 95% CI: 2.52-5.28). The least impact was demonstrated by the repair variables (OR=1.56; 95% CI: 0.22-10.83). and Pooling of the effect sizes of different demographic predictors, associated anomalies, and repair variables from the different studies reporting the regression modeling of re-intervention data demonstrated different significant predictors. Among these predictors, the associated anomalies (hypoplastic aortic arch) demonstrated the greatest impact (OR=1.89; 95% CI: 0.88-4.06). The least impact was demonstrated by the repair variables (OR=1.8; 95% CI: 0.94-3.44).
Therefore, we believe the results of our meta-analysis are trustworthy, although the selection bias of the included NRCTs did lack matched pairs and propensity score matching. Finally, we initially planned to include studies comparing surgery versus stent implantation which was regarded as a more modern approach, Stent implantation was reported to lower risk of potential aneurysm formation.