Vol. 30 No. 1 (2026)
CONGENITAL HEART DISEASES

Early and long-term outcomes of aortic coarctation repair: a prospective two-center study

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  • Pavel V. Teplov,
  • Egor M. Gvozd,
  • Alexandr Yu. Miller,
  • Yliya N. Polyakova,
  • Valeriy A. Sakovich,
  • Ekaterina N. Amansakhatova,
  • Iliya A. Soynov
Pavel V. Teplov
ФГБУ "Федеральный центр сердечно-сосудистой хирургии" г. Красноярска
Bio
Egor M. Gvozd
FCCSH Krasnoyarsk
Alexandr Yu. Miller
FCCSH Krasnoyarsk
Yliya N. Polyakova
FCCSH Krasnoyarsk
Valeriy A. Sakovich
FCCSH Krasnoyarsk
Ekaterina N. Amansakhatova
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
Iliya A. Soynov
Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2026-1-26-39

Published 2026-04-14

Keywords

  • aortic arch hypoplasia; aortic coarctation, aortoplasty; congenital heart disease; pediatric cardiology; pulmonary homograft

How to Cite

Теплов, П. В., Gvozd, E. M., Miller, A., Polyakova, Y. N., Sakovich, V. A., Amansahatova, E. N., & Soynov, I. A. (2026). Early and long-term outcomes of aortic coarctation repair: a prospective two-center study. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 30(1), 26–39. https://doi.org/10.21688/1681-3472-2026-1-26-39

Copyright (c) 2026 Teplov et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Introduction. Recoarctation of the aorta, arterial hypertension and main bronchus compression remain the major complications following surgical correction of aortic coarctation and aortic arch hypoplasia, despite high effectiveness and low mortality in most patients.

Objective. To evaluate early and long-term outcomes of surgical treatment in neonatal patients with aortic coarctation, comparing native tissue repair (such as extended end-to-end anastomosis) to patch aortoplasty techniques.

Methods. This two-center, prospective, randomized study analyzed the outcomes of surgical repair for aortic coarctation with arch hypoplasia in a pediatric patient cohort, which included 105 neonates. According to the study design, all patients were divided into two groups based on the surgical technique used: patch aortoplasty (70 patients) and repair with an extended end-to-end anastomosis (35 patients).

Results. In-hospital mortality in the patch repair group was 5 (7.1 %) patients, compared to 3 (8.6 %) patients in the native tissue repair group, p > 0.999. The only independent risk factor for mortality, regardless of the surgical technique performed, was the duration of cardiopulmonary bypass (OR with 95 % CI 1.374 to 45.242, p = 0.016). The sole predictor for the development of aortic recoarctation in the long-term postoperative period was a peak gradient across the isthmus exceeding 14 mm Hg (HR = 3.75; p < 0.001). The use of the patch repair surgical strategy was associated with a reduced risk of developing arterial hypertension (HR = 0.385, p = 0.046).

Conclusion. Both common surgical strategies demonstrate comparable efficacy in treating coarctation and hypoplasia of the aortic arch in newborns. Regardless of the surgical approach, primary attention should be paid to the individual anatomical features of the aortic arch, patient condition, and associated congenital heart defects. However, in all patients, complete resection of ductal tissue is mandatory to prevent the development of aortic recoarctation and residual arterial hypertension. 

Received 19 January 2026. Revised 26 January 2026. Accepted 28 January 2026.

Informed consent
The patient’s official representative has provided informed consent for the use of the recordings for medical purposes.
Funding
The research was carried out within the state assignment of Ministry of Health of Russian Federation (No. 124022500251-0).
Conflict of interest
The authors declare no conflict of interest.

Contribution of the authors 

Conception and study design: P.V. Teplov, E.N. Amansakhatova, I.A. Soynov

Data collection and analysis: P.V. Teplov, A.Yu. Miller, E.M. Gvozd

Statistical analysis: E.M. Gvozd, Yu.N. Polyakova, I.A. Soynov

Drafting the article: P.V. Teplov, E.N. Amansakhatova, I.A. Soynov

Critical revision of the article: V.A. Sakovich, I.A. Soynov

Final approval of the version to be published: all authors

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