REVIEW  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2020 August;61(4):478-88

DOI: 10.23736/S0021-9509.20.11075-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Neonatal management of aortic coarctation with ventricular septal defect: a systematic review and meta-analysis

Reda KASDI ^{1, 2} ✉, Karl BOUNADER ¹, Mohamed LEMDANI ²

¹ Department of Cardiac Surgery, Rennes University Hospital, Rennes, France; ² Department of Biomathematics, Faculty of Pharmacy and Biology, University of Lille, Lille, France

INTRODUCTION: Neonatal management of aortic coarctation with ventricular septal defect is still under debate between the one-stage full repair by sternotomy versus the staged repair of the coarctation first by thoracotomy (with or without banding the pulmonary artery) followed later by subsequent closure of the ventricular septal defect.
EVIDENCE ACQUISITION: The aim of this review was to synthesize the evidence in literature since 1980 for the neonatal population. A meta-analysis compared mortality between the two strategies.
EVIDENCE SYNTHESIS: The analysis did not find a superiority of a strategy over the other regardless of the surgical era studied. Recoarctation rates of both strategies are presented and a management algorithm is suggested.
CONCLUSIONS: Instead of comparing between the two strategies, a case-adapted management considering the anatomy of the ventricular septal defect and of the aortic arch is discussed to address this association of lesions though presenting with a wide range of settings.

KEY WORDS: Aortic coarctation; Ventricular septal defect; Hypoplastic aortic arch