Treatment for correction of coarctation of the aorta in children: systematic review of literature

• Grant number: 11/21140-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2012
• End date: September 30, 2012
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Paulo Eduardo de Oliveira Carvalho
• Grantee: Lucas Cezar Garcia
• Host Institution: Faculdade de Medicina de Marília (FAMEMA). Secretaria de Desenvolvimento Econômico (São Paulo - Estado). Marília , SP, Brazil

Abstract

The coarctation of the aorta is a narrowing in any region between the distal aortic arch and the bifurcation of the abdominal aorta, accounting for 5% to 7% of congenital heart disease. The average age of death without repair is 31 years and 76% of deaths are attributed to complications. Surgical repair is the oldest type of therapy, first described more than 50 years, and the anastomosis was end to end the procedure most commonly used today. The most common complications after surgery are residual hypertension and pulmonary complications. In 1982, balloon angioplasty was first described as a viable modality, although recoarctation, aneurysm, and aortic dissection are the main disadvantages. Although surgical intervention remains the treatment of choice in the pediatric population, balloon angioplasty appears to be a less invasive treatment alternative for correction of discrete coarctation of the aorta. In neonates and children, some studies indicate similar results between the two types of treatment, while others demonstrated a lower recoarctation and aneurysm formation associated with follow-up as a strategy for surgical repair. Objective: to evaluate the effectiveness and safety of balloon angioplasty versus open surgery for repair of coarctation of the aorta in children. Method: this is a systematic review of randomized clinical trials. Will be held electronic search with a specific search strategy for this review using the following databases: MEDLINE (1966-2012), Register of the Cochrane Controlled Trials (CENTRAL) (2012), EMBASE (1974-2012), Web of Science (2012 ) LILACS (1988-2012) and will be selected studies fulfilling the inclusion criteria. It will assess the outcomes according to improvement in quality of life and the possible complications after the intervention. References found will be evaluated by the search strategy and applied inclusion criteria in selected studies using the scales of methodological quality of the Cochrane Handbook.(AU)