EARLY DIAGNOSIS, THERAPEUTIC APPROACHES AND LONG-TERM PROGNOSIS OF PEDIATRIC AORTIC COARCTATION: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.56238/revgeov16n5-289Keywords:
Aortic Coarctation, Congenital Heart Disease, Early Diagnosis, Surgical Treatment, PrognosisAbstract
Considering the clinical relevance of aortic coarctation (CoAo) in pediatric populations and the risks associated with late diagnosis, it is justified to synthesize recent evidence regarding its identification, management and clinical evolution. This study aims to analyze scientific publications from 2020 to 2025 addressing early diagnosis, surgical and endovascular interventions, and long-term prognosis in children with CoAo. To this end, a systematic review was conducted, registered in PROSPERO (ID 1051344) and developed according to PRISMA 2020 guidelines, using searches performed in PubMed, SciELO and BVS. A total of 257 studies were identified, of which nine met the inclusion criteria. The findings indicate that fetal and postnatal echocardiography remain the primary diagnostic tools, while computed tomography angiography contributes to monitoring postoperative complications. Surgical end-to-end repair shows greater effectiveness in neonates and infants, and endovascular procedures represent a viable alternative for older children and cases of recoarctation. Persistent arterial hypertension was reported in a significant proportion of patients, reinforcing the importance of long-term follow-up. Thus, early diagnosis, appropriate therapeutic intervention and continuous monitoring are essential to improving prognosis in pediatric CoAo.
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References
BHATT, A. B. et al. Isolated coarctation of the aorta: current concepts and perspectives. Frontiers in Cardiovascular Medicine, Lausanne, v. 9, p. 1-14, 2022. DOI: https://doi.org/10.3389/fcvm.2022.817866.
DELL’AQUILA, A. M. et al. Surgical treatment of aortic coarctation in neonates and infants: is it always necessary to repair associated cardiac anomalies? Minerva Cardioangiologica, Torino, v. 68, n. 4, p. 478–485, 2020. DOI: https://doi.org/10.36660/abc.20190558.
HE, F. et al. Endovascular treatment of aortic coarctation using covered balloon-expandable stents: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine, Lausanne, v. 11, p. 1–14, 2024. DOI: https://doi.org/10.3389/fcvm.2024.1439458.
KAČAR, P.; PAVŠIČ, N.; PROKŠELJ, K. Exercise-induced hypertension after aortic coarctation repair: our experience and a systematic review. Kardiologia Polska, Warsaw, v. 82, n. 6, p. 625–631, 2024. DOI: https://doi.org/10.33963/v.phj.100636.
LIMA, A. et al. Single-lung ventilation in infants for surgical repair of coarctation of the aorta without cardiopulmonary bypass. Revista Brasileira de Cirurgia Cardiovascular, São José do Rio Preto, v. 38, n. 2, p. 147–154, 2023. DOI: https://doi.org/10.21470/1678-9741-2022-0505.
OLIVEIRA, L. A. et al. Coarctação da aorta em crianças: diagnóstico precoce e evolução clínica. Revista Brasileira de Cirurgia Cardiovascular, São José do Rio Preto, v. 36, n. 1, p. 68–74, 2021. DOI: https://doi.org/10.25248/REAS.e7254.2021.
SENER, T. F. et al. Surgical versus transcatheter intervention for aortic coarctation: medium-term results. Heart Surgery Forum, Memphis, v. 26, n. 1, p. E098–E104, 2023. DOI: https://doi.org/10.1532/hsf.5035.
SILVA, J. P. et al. Role of computed tomography angiography in the short-term follow-up of aortic coarctation repair. Revista Brasileira de Cirurgia Cardiovascular, São José do Rio Preto, v. 39, n. 1, p. 1–7, 2024. DOI: https://doi.org/10.21470/1678-9741-2023-0220.
VILLALAÍN, C. et al. Diagnostic accuracy of prenatal ultrasound in coarctation of aorta: systematic review and individual participant data meta-analysis. Ultrasound in Obstetrics & Gynecology, London, v. 63, n. 4, p. 446–456, 2024. DOI: https://doi.org/10.1002/uog.27576.
