title: A systematic review and meta-analysis of outcomes of transcatheter stent implantation for the primary treatment of native coarctation.
abstract: OBJECTIVE
  The treatment of native coarctation of aorta (CoA) has evolved since surgery performed in 1944, followed by transcatheter balloon angioplasty and recently, widely adopted stent implantation. Despite good results demonstrated with stent implantation, a systematic review and meta-analysis (SRMA) looking at the efficacy and safety of the intervention, particularly in younger population is yet to be done. We aimed to obtain pooled estimates of the success and complication rates after transcatheter stent implantation in the treatment of native CoA based on SRMA.
  
  
  METHODS
  We searched literature published until 31 Dec. 2015, reporting outcomes of transcatheter stent implantation in the treatment of native CoA. The pooled estimates were obtained using the random effect model.
  
  
  RESULTS
  Seventeen reports comprising 561 patients were included. Fourteen studies reported 100% success rate, the lowest was 77%, the largest study reported 81% using a definition of systolic pressure difference of less than 15mmHg. The pooled estimate of overall success rate was 98% (95% CI: 94.5-100.0; I2=65%, heterogeneity test p<0.001). Six out of 17 studies reported zero complication. Two studies, however, reported complications in almost half of the cohort. The pooled estimate of rate of complications was 10% (95% CI: 5.1-15.5; I2=72%, heterogeneity test p<0.001). Three studies comprising only children, 62, with mean age of 11.1 (4-19) years reported high mean success rate at 98% with only 1 failure.
  
  
  CONCLUSIONS
  There is a high success rate with a small complication rate with stent implantations for native CoA even as the treatment is brought to younger age group.
authors: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: linqi_yang@nuhs.edu.sg.
authors: Linqi
authors: L
authors: Yang
authors: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: xiuzhen_chua@nuhs.edu.sg.
authors: Xiuzhen
authors: X
authors: Chua
authors: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: paerdd@nus.edu.sg.
authors: Dimple D
authors: DD
authors: Rajgor
authors: Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Electronic address: bee_choo_tai@nuhs.edu.sg.
authors: Bee Choo
authors: BC
authors: Tai
authors: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore. Electronic address: swee_chye_quek@nuhs.edu.sg.
authors: Swee Chye
authors: SC
authors: Quek
mesh_terms: D001017:Aortic Coarctation / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D002648:Child; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010372:Pediatrics / Q000379:methods; D016896:Treatment Outcome
keywords: Coarctation; Efficacy; Pediatrics; Safety; Systematic review; Transcatheter stent implantation