Abstract
<jats:p>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.</jats:p>