Repair Techniques Research Articles

TAPP versus lichtenstein techniques for bilateral inguinal hernia repair: A systematic review and meta-analysis.

Inguinal hernia repair is one of the most common surgical procedures performed worldwide. However, very few studies report data on the laparoscopic advantages of bilateral inguinal hernia (BIH) repair over the open approach. Therefore, this meta-analysis was conducted to compare the effectiveness of the laparoscopic trans-abdominal pre-peritoneal (TAPP) technique with the open Lichtenstein repair technique (OLR) for the repair of BIH. A detailed literature search was conducted on PubMed, Google Scholar, and Cochrane Library for comparative studies between TAPP and OLR techniques for repair of BIH. RevMan Version 5.4 was used for data analysis. The Inverse Variance statistical method was used to analyze the primary outcomes and the Mantel-Haenszel statistical method was used to analyze the secondary outcomes. The effect measure was reported as a Risk Ratio. There was no significant difference in recurrence between the two groups. A significant difference was seen in duration of post-operative hospital stay, operative time, pain score on VAS criteria on post-operative Day 1, pain score on VAS criteria on post-operative Day 7, and complications, all in the favor of TAPP except for operative time which was in the favor of OLR. TAPP was found to be superior to OLR in terms of duration of post-operative hospital stay, pain scores on VAS criteria on post-operative days 1 and 7, and complications, whereas OLR was found superior only in terms of operative time. For recurrence, there was no significant difference between the two groups.

Tethered cord prevalence among patients with prenatal or postnatal myelomeningocele repair.

Myelomeningocele (MMC) is a severe form of spina bifida characterized by spinal cord extrusion into a cerebrospinal fluid (CSF) filled sac which may lead to lifelong disability. Repair of these lesions have classically occurred shortly after birth, but more recently, prenatal myelomeningocele repair techniques have been elucidated. This study aimed to investigate the outcome of surgery, particularly with subsequent spinal cord tethering, in patients with prenatal myelomeningocele closure and those with postnatal repair surgery. In this retrospective study which assessed patients from April 2002 to April 2020, the data of 18 total patients with MMC were reviewed. Nine patients from each group were included, closed prenatally or postnatally, respectively. Demographic information including age and sex, birth week, infant comorbidities, presence of dermoid or lipoma, cutaneous stigmata, total number and timing of detethering procedures, presence of Chiari malformation, and need for VPS was obtained. Eighteen patients including nine infants closed prenatally and nine infants with myelomeningoceles closed postnatally were reviewed. The mean age was 4 ± 3years and 6.22 ± 2.4 in prenatal and postnatal retrospectively. There was a significant relationship between the number of detethering procedures (p-value = 0.03) and the need for a ventriculoperitoneal shunt (VPS) (p-value = 0.01) between the groups, with the prenatal closure group having lower rates of each. There was no significant difference between the groups in regard to the mean age at the detethering procedure (p = 0.4), sex (p = 0.09), birth week (p = 0.8), comorbidities (p = 0.8), presence of intraspinal dermoid or lipoma (p = 0.09), presence of cutaneous stigma (p = 0.08), Chiari (p = 0.6), fatty filum (p = 0.08), syrinx (p = 0.4), bone anomaly (p = 0.4), and spina bifida neurological scale (p = 0.66). There was a significant relationship between the two groups in terms of the number of detethering procedures, and the need for VPS. Our data represents a possible difference in the need for detethering surgeries and ventriculoperitoneal shunt placements between patients with prenatal and postnatal myelomeningocele closures.

Surgical Technique for Repair of Tegmen Dehiscence with Encephalocele: A Retrospective Study

Tegmen dehiscence with encephalocele presents certain surgical challenges, necessitating innovative approaches to improve patient outcomes and minimize complications. Here we aim to evaluate the safety and efficacy of a novel middle cranial fossa craniotomy technique. Nineteen adult patients with radiographically confirmed tegmen dehiscence with encephalocele were included. Patients underwent a middle cranial fossa craniotomy technique for tegmen dehiscence repair, utilizing a split thickness bone graft, pedicled pericranial flap, and hydroxyapatite for extradural repair and with an inlay graft for the intradural repair. The primary outcome measured was major perioperative complications or need for revision surgery while secondary outcome measured was the resolution or improvement of preoperative symptoms associated with tegmen dehiscence. Our series encompassed tegmen dehiscence repairs in 19 patients, with an average age at surgery of 51 years (range 24 to 82). The average follow-up time was 8.80 months (range 0.43 to 27.62 months). Patients commonly presented with symptoms such as hearing loss (n=8), otorrhea (n=8), fullness or ear pressure (n=6), dizziness or imbalance (n=6), or a history of meningitis (n=4), among others. Postoperatively, symptoms resolved completely in 42% of patients (n=8) and partially in 58% of patients (n=11). Notably, no patients required revision surgery or developed new dehiscences in the follow-up period. Our middle cranial fossa craniotomy technique for tegmen dehiscence with encephalocele repair demonstrated promising postoperative outcomes, with complete or partial symptom resolution in all patients and no major complications. Our findings suggest that this technique is a safe and effective approach for tegmen dehiscence repair.

Significantly smaller lateral extrusion was observed within 24 weeks after all-inside suture repairs of radial tear in the middle segment of lateral meniscus compared to inside-out repairs.

To evaluate the postoperative meniscal extrusion between all-inside suture (AIS) and trans-capsular suture (TCS) repair techniques. Thirteen patients (mean age, 19.4 years) underwent AIS repairs using only sutures (AIS group) for radial tears in the middle segment of the lateral meniscus (RTMLM), and seven patients (mean age, 20.3 years) underwent inside-out repairs among TCS (TCS group). For all cases, lateral (LE), anterior (AE) and posterior (PE) meniscal extrusions of the lateral meniscus were measured during preoperative and 3-, 12- and 24-week postoperative MRIs. Then, the change of each extrusion from preoperative to each postoperative period was calculated as ∆LE, ∆AE and ∆PE. There was no significant difference between the AIS and TCS groups in the preoperative extrusions. As for postoperative extrusions, only ∆LEs in the AIS group was significantly smaller than those in the TCS group at all postoperative periods (-1.5 ± 1.7 vs. 0.9 ± 0.7 mm at 3-week, -0.9 ± 0.9 vs. 0.4 ± 0.9 mm at 12-week and -0.3 ± 1.0 vs. 0.6 ± 1.1 mm at 24-week postoperation). In ∆AEs and ∆PEs, at all three postoperative periods, there were no significant differences. Postoperative LE, AE and PE on MRIs after AIS and TCS repairs for RTMLM were investigated. Significantly smaller lateral extrusion was observed within 24 weeks after AIS repairs of RTMLM compared to TCS repairs, which could lead to stabilization of the repair site and prevent degenerative changes. Case-control study, retrospective comparative study, Level Ⅲ.

Iridodialysis repair using a modified sewing machine technique

A large iridodialysis can present with both visual and cosmetic disturbances, and therefore, surgical intervention is indicated. We describe a modified sewing machine technique in repairing large iridodialysis without the indication of an extensive scleral groove. Another modification made was a scleral flap. The scleral flap provides better control on the position of the knot and its whisker, allowing full coverage and eliminating the risk of whisker exposure and eventual conjunctival erosion. This technique for iridodialysis repair provides better cosmetic results, especially for extensive iridodialysis. It is also more economical and involves simple, safe, and efficient surgical maneuvers in repairing iridodialysis.

Intrathoracic Scapular Dislocation After Total Shoulder Arthroplasty

Case: A 75-year-old woman status post total shoulder arthroplasty and posterior rib resection 29 years previously experienced a low-energy intrathoracic scapular dislocation (ISD). Closed reduction under anesthesia was unsuccessful, and she required open surgical repair performed by a novel modification of Kibler's technique for medial scapular muscle repair. Conclusion: This case is unique because increased range of motion after successful arthroplasty allowed her shoulder to flex forward enough to result in ISD. Successful surgical repair was performed by a technique previously not described.

Comparative analysis of robotic and laparoscopic techniques in hiatal hernia and crural repair: a review of current evidence and outcomes.

The purpose of this narrative review is to evaluate the implementation of robotic surgery in hiatal hernia and crural repair, based on the existing literature and to compare this approach to other established techniques. We performed a non- systematic literature search of PubMed and MEDLINE on February 25, 2024 for papers published to date focusing on the surgical repair of hiatal hernias using the robotic platform. After eliminating publications based on eligibility criteria, 13 studies were selected for analysis. Robotic surgery is increasingly utilized in hiatal hernia repair due to its enhanced ergonomics and superior visualization capabilities. Operative times vary, with some studies indicating longer durations for robotic surgery (e.g., Giovannetti et al. demonstrated median operative time of 196min for robotic compared to 145min for laparoscopic) while others report shorter times (e.g., Lang F et al. demonstrated 88min for robotic versus 102min for laparoscopic). Recurrence rates between robotic and laparoscopic repairs are comparable, with reported recurrence rates of 1.8% for robotic and 1.2% for laparoscopic approaches by Benedix et al. Robotic surgery offers potential advantages, including reduced intraoperative blood loss (e.g., Giovannetti et al. mentioned median blood loss of 20ml for robotic versus 50ml for laparoscopic). The length of hospital stay and postoperative complication rates also vary, with some studies suggesting shorter stays and fewer complications for robotic surgery as surgeons become more proficient. Soliman et al. reported a statistically significant reduction in complication rates with robotic surgery (6.3% versus 19.2%). Robotic surgery presents promising results regarding the length of hospital stay, conversion rate to open surgery and postoperative complication rates when compared to laparoscopy based on the existing literature. Despite the lack of striking differences, robotic hiatal hernia repair is a valid and evolving approach.

Managing Subscapularis in Shoulder arthroplasty

Managing subscapularis forms an integral part of shoulder arthroplasty and the ideal technique for subscapularis release and repair during shoulder arthroplasty is still under debate. The three common techniques are tenotomy, peel and lesser tuberosity osteotomy (LTO). Current literature from clinical studies does not show any difference in the outcome between the 3 techniques. However biomechanical studies favour LTO. Subscapularis sparing approach can be an alternative solution allowing early rehabilitation but needs further clinical studies to assess its longterm benefits. Failure of subscapularis repair in anatomical shoulder replacement can lead to pain, loss of movements, instability and loosening of implants. Treatment options include revision repair, tendon transfer, reconstruction with allograft tendon and revision to reverse shoulder arthroplasty (RSA). Repairing subscapularis in RSA can improve rotations and stability, however it also has adverse biomechanical effects on deltoid. Absence of subscapularis repair is seen to affect stability only in medialised implant designs, while no such effects are seen in lateralised design implants.

Assessment of the Right Ventricle Function in Patients With Significant Tricuspid Regurgitation: A Review.

Tricuspid regurgitation (TR) is an increasingly prevalent condition, especially in older populations, and presents significant challenges due to its association with right heart failure, hospital admissions, and high mortality rates. The management of TR has evolved, with new percutaneous valve repair and replacement techniques emerging alongside traditional surgical approaches. However, accurately assessing right ventricular (RV) function-a key prognostic factor in TR-remains difficult due to the RV's unique anatomy and sensitivity to loading conditions. Current echocardiographic methods, such as Tricuspid Annular Plane Systolic Excursion (TAPSE), S' wave analysis, and RV fractional area change (FAC), offer valuable insights but have limitations, particularly regarding load dependence and incomplete assessment of RV function. Advances in 3D echocardiography and myocardial strain imaging provide more comprehensive evaluations, yet challenges persist in integrating these measures in routine clinical practice. The review highlights the importance of a multimodal approach to RV assessment in TR patients, considering both the right atrium and pulmonary artery interactions, and explores potential future tools such as myocardial work and dynamic testing to improve prognostic accuracy and patient outcomes.

Outcomes of the Lateral Caval Flap and Conventional Techniques for Repair of Right-Sided Partial Anomalous Pulmonary Venous Connection in Adults

Outcomes of the Lateral Caval Flap and Conventional Techniques for Repair of Right-Sided Partial Anomalous Pulmonary Venous Connection in Adults

The current status and development of nerve repair techniques for bilateral vocal cord paralysis

The related research of nerve repair for bilateral vocal cord paralysis（BVCP） can be traced back to a century ago. There is still no standardized surgical therapeutic schedule and the evaluation of curative effect, due to the variability and complexity of laryngeal nerve innervation. Otolaryngologists have been constantly weighing and improving the surgical plan in relieving airway obstruction, maintaining vocal function and reducing cough to protect the normal physiological function of the larynx. Different medical institutions have great differences in the treatment methods. Many studies and literatures were published on the treatment of BVCP, yet have few related works on the application of it's nerve repair technology presently. The research progress of nerve repair technology for BVCP were described, along with its developing trend, aiming to lay the foundation for the future technical exploration and development.

La reparación aislada presenta mayor altura patelar postoperatoria según el índice de Insall-Salvati en comparación con la aumentación biológica en roturas agudas del tendón rotuliano

Background and objectivePatellar tendon ruptures (PTR) are rare but highly disabling injuries. Surgical treatment is the standard approach. Postoperative patellar height (PH) is used to determine the success of the intervention, with various indices described in the literature. The objective of the study was to determine if there are differences in PH according to the Insall-Salvati index in the immediate postoperative period and at 4 months, between two groups of patients operated on for acute PTR: The first group underwent isolated repair techniques (IR) and the second group had biological augmentation with autograft or allograft added to the repair (BAR). Our hypothesis was that the BAR group would have lower PH in the immediate postoperative period and at 4 months. Materials and methodsAll patients with acute PTR treated at our center between 2016 and 2022 were reviewed retrospectively. Patients with re-rupture of the operated tendon and those with non-biological augmentation were excluded. PH according to the Insall-Salvati index was measured in radiographs taken the day after surgery and at 4 months postoperatively by three orthopedic surgeons with a subspecialty in knee surgery, independently. A fourth blind evaluator analyzed the measurement results, determining the average PH and the intraclass correlation coefficient for absolute agreement among the three evaluators. The primary outcome was the difference in PH between both groups the day after surgery and at 4 months. The secondary outcome was the difference in PH between the immediate postoperative measurement and at 4 months in both groups. ResultsThis was a retrospective observational study. Thirty-one operated knees were included. IR was performed on 15 knees (48.38%), and biological augmentation was added in 16. The intraclass correlation coefficient between observer 1 and 2 was 0.88; between 2 and 3 it was 0.89; and between observers 1 and 3 it was 0.92, showing at least substantial agreement among observers. The average Insall-Salvati index the day after surgery and at 4 months was 1.15 and 1.21 for the IR group, and 0.97 and 1.07 for the BAR group, respectively. A statistically significant difference in the Insall-Salvati index was found between the two groups, both in the measurement taken the day after surgery (p<0.0001) and at 4 months (p=0.0002). Additionally, significant differences were observed indicating an increase in average PH when comparing the immediate postoperative measurement and at 4 months in each study group (for IR p=0.0016 and for BAR p<0.0001). ConclusionsThe Insall-Salvati index was significantly lower in BAR cases both the day after surgery and at 4 months postoperatively. Additionally, a significant increase in PH was observed at 4 months, regardless of the surgical technique used. Substantial inter-observer agreement was achieved for PH measurement in this cohort.

Three-Point Contact Repair Technique for Partial Subscapularis Tears Using U-Stitch and Cow Hitch Knot Loaded on a Single Knotless Anchor: Simple, Reliable and Quick Method

The importance of repairing the subscapularis tendon to facilitate restoration of the rotator cuff force couple is obvious. However, identifying and repairing subscapularis tears can be challenging for surgeons. In this technical note, we present our preferred surgical method for Lafosse type 1, 2, and 3 and Yoo and Rhee type 1-2A and 2B subscapularis tears, providing a 3-point suture contact achieved with FiberTape (Arthrex) and knotless anchors. In this technique, fiber suture is placed into the superolateral edge of the subscapularis tendon as a traction stitch (cow hitch knot). Second, the FiberTape is passed through the medial upper and lower parts of the tendon, just perpendicular to the fibers, using a suture passer. The FiberTape’s free ends remain on the tendon’s anterior side, shaping a U form. The U-shaped FiberTape and traction suture are loaded to a knotless anchor and placed on the footprint area. This creates a 3-point contact between the FiberTape U-suture and the cow hitch knot on the area. We believe that this technique provides fast and reliable fixation due to its 3-point contact application and simplicity.

"Fully endoscopic preperitoneal ascending suprapubic approach for minimally invasive repair of anterior and lateral abdominal wall hernias".

The aim of this work is to describe the rational, feasibility and clinical and Quality-of-life improvement results of a fully endoscopic preperitoneal repair for midline and lateral abdominal wall hernias, starting from the space of Retzius in a "bottom-to-up" approach. An observational prospective data-collected and quality of life study is performed in selected patients with less than 10cm. in diameter midline and lateral abdominal wall hernias. A suprapubic upward e-TEP technique from a previously dissected Retzius space, is performed in all cases. The surgical goal is to perform a total free-tension abdominal wall reconstruction followed by a prosthetic hernioplasty. Clinical Data is classified in preoperative, intraoperative, and postoperative variables, including a quality-of-life clinical evaluation based on an improvement of HerQLes score. A total of 30 patients underwent this approach from September 2017 to October 2022 in a single-surgeon practice. A total restoration of the previous abdominal wall anatomy and a prosthetic repair were achieved in all cases. The mean operative time was 142.53min, with a significant shorter time in lateral hernias approach. Minor complications (Clavien-Dindo I) were collected in 10% of the patients. Major complications (Clavien-Dindo IIIb) occurred in 6.66% of the patients. The mean pain at discharge was 1.83 VAS, with a significant lower pain in M-eTEP approach for lateral hernias. The mean hospital stay was 42.4h. No seroma, hematoma, chronic pain, or recurrence was observed in the mean follow-up (20.33months). A clinical and quality of life improvement was found in 92.9% of the patients, measured by a minimal clinical important difference (MCID) between preoperative and postoperative HerQLes score. Despite being a technically demanding approach, the results obtained by this approach are compatible in safety and feasibility with other minimally invasive preperitoneal hernia repair techniques, in addition to obtaining a significant improvement in the quality of life of patients.

Management of Rotator Cuff Tears in Severely Osteoporotic Patients

Management of rotator cuff tears (RCT) in osteoporotic patients presents significant challenges for treating clinicians because of compromised bone quality. We present a case series of 2 patients with RCT and severe osteoporosis highlighting the complexities of operative and nonoperative management and underscoring the importance of preoperative optimization and careful surgical planning in this vulnerable population. Patient 1 experienced initial improvement postarthroscopic RCT repair but required revision surgery because of anchor pullout, with eventual conversion to reverse total shoulder arthroplasty. Patient 2 faced intraoperative challenges because of previously undiagnosed osteoporosis, leading to difficulties in securely placing suture anchors, and was referred to the fracture liaison service (FLS) for osteoporosis management postoperatively. A multifaceted approach integrating preoperative optimization, advanced surgical techniques, and postoperative management is advised to improve operative success. Extensive perioperative bone quality assessments and augmentation strategies are warranted, including medication comanagement through an FLS if available. Detailed surgical planning is crucial, focusing on arthroscopic repair technique while considering various anchor factors to mitigate failure including proper placement, design, and pullout analysis. Intraoperative bone augmentation with materials such as calcium phosphate, magnesium phosphate, and polymethyl methacrylate cements significantly improves anchor fixation strength in osteoporotic bone. Consideration of a transosseous approach and potential for conversion to an open procedure is also an option when necessary. This review highlights the unique challenges and potential options available to treating clinicians when managing RCT in osteoporotic patients. Continued research and refinement of emerging treatment strategies are essential to improve outcomes and quality of life in this patient population.

Arthroscopic Repair of the Medial Meniscal Root Tear: A Simple Surgical Technique

Medial meniscal root tears pose significant challenges in orthopaedic practice, disrupting knee biomechanics and predisposing to degenerative changes. This article introduces an arthroscopic repair technique tailored for posterior root tears of the medial meniscus. The procedure involves meticulous preoperative evaluation, arthroscopic identification, and suture anchor fixation to restore normal knee mechanics. Inclusion and exclusion criteria ensure suitability, whereas postoperative care emphasizes early rehabilitation. By elucidating the surgical technique and outlining clinical implications, this article aims to equip surgeons with effective strategies for managing this challenging orthopaedic condition.

Assessment of recycling and repair methods for discontinuous glass fiber reinforced vitrimer composites with reclaimed parts

In the context of fiber-reinforced polymer composites, the pursuit of sustainability is of paramount importance to promote environmentally responsible practices. Vitrimer materials have recently gained significant attention for their potential to enable repair and recycling, rendering them an attractive choice for manufacturing eco-friendly composites while maintaining mechanical strength akin to a thermoset resin like epoxy. This study specifically focuses on glass fibers, and delves into the examination of mechanical properties using both chemical and mechanical recycling methods for quasi-isotropic, randomly dispersed discontinuous glass fiber-reinforced vitrimer composites. It places specific emphasis on the optimization of factors to promote sustainable production. The findings indicate that chemical recycling methods are remarkably effective, resulting in the almost complete restoration of mechanical properties when appropriately selected process parameters are applied. Additionally, this study investigates diverse repair techniques, with the overlap repair method exhibiting the highest degree of recovery. These findings underscore the remarkable potential of glass fiber reinforced vitrimer composites, characterized by their high mechanical properties, for applications in various industries, particularly in structural contexts. Overall, this study highlights the significant reduction in composite waste achievable through recycling and repair strategies, aligning with the broader goal of advancing sustainability within the domain of engineering and manufacturing.

Secondary mitral regurgitation surgical management: a narrative review.

The most common valvular heart disease in the US is moderate to severe mitral regurgitation (MR). Function MR or secondary MR comprises many of these cases. Moderate and severe secondary MR are independently associated with increased all-cause mortality and rehospitalization for heart failure. Both ischemic and nonischemic cardiomyopathy can cause secondary MR via similar pathophysiology that leads to inadequate valve leaflets coaptation. The management of secondary MR is complex. The optimal treatment strategy for secondary MR remains controversial, reflected in the vast array of treatment options and the complexity of therapeutic decision-making. Several surgical mitral valve repair techniques have been described in the literature. Many of these aims to facilitate adequate valve leaflet coaptation. In this review, the pathophysiology of MR is described with a focus on evaluating and managing secondary MR. A literature review was performed using PubMed and Google Scholar. Clinical trials, meta-analyses, randomized controlled trials, reviews, and systematic reviews were considered from January 1, 1995 through December 31, 2022. Articles published in languages other than English with limited text availability were excluded. Optimal therapeutic approach in severe secondary MR is complex and several patient factor should be considered. We provide a framework for the surgical management of secondary MR based on echocardiographic parameters, the presence of ischemia, and myocardial viability. Further study is needed to guide the selection of patients most likely to benefit from mitral valve repair or replacement in the setting of secondary MR.

Failure and complication rates following meniscal all-inside and inside-out repairs: A systematic review and meta-analysis.

This study examines failure rates, complication rates and patient-reported outcome measures (PROMs) for meniscal all-inside (AI) and inside-out (IO) repair techniques. A systematic search was conducted on PubMed, Embase and Cochrane (inception to January 2024) assessing for Level I-III studies evaluating outcomes after meniscal repair. The primary outcome regarded differences in failure rates between AI and IO repair techniques. Secondary outcomes included a comparison of complication rates and PROMs. Quality assessment was performed using the Grading of Recommendations Assessment, Development and Evaluation and Methodological Index for Non-Randomized Studies criteria. A meta-analysis was conducted for outcomes reported by more than three comparative studies. A total of 24 studies (13 studies and 912 menisci for AI vs. 17 studies and 1,117 menisci for IO) were included. The mean follow-up ranges were 22-192 months (AI) and 18.5-155 months (IO). The overall reported AI failure rate ranged from 5% to 35% compared to 0% to 25% within the IO group. When comparing meniscal repair failure rates in the setting of concomitant anterior cruciate ligament reconstruction, the AI group had a failure rate (AI: 5%-34%; IO: 0%-12.9%). The complication rate ranged from 0% to 40% for AI and 0% to 20.5% for IO. Post-operative PROM scores ranged from 81.2 to 93.8 (AI) versus 89.6 to 94 (IO) for IKDC and 4.0-7.02 (AI) versus 4.0-8.0 (IO) for Tegner. Upon pooling of six comparative studies, a significantly lower failure rate favouring the IO technique was observed (15.9% AI vs. 11.1% IO; p = 0.02), although this result was influenced by a study with a predominantly elite athlete population. Moreover, no significant differences were found regarding complication rates between cohorts (7.3% AI vs. 4.8% IO; p = 0.86). The present study underscores comparable clinical success between AI and IO meniscal repair techniques, with both techniques demonstrating similar complication rates. However, the AI repair technique was associated with 1.77 times higher odds of failure compared to the IO cohort. Level III.

Comparative Analysis of Surgical and Endovascular Approaches for Isolated Aortic Coarctation Repair across Age Groups: Outcomes and Long-Term Efficacy.

Background: Aortic coarctation, a condition characterized by localized narrowing of the aorta, can be managed with either surgical or endovascular techniques. This study aims to compare these approaches concerning long-term outcomes, particularly re-coarctation rates and late arterial hypertension. Methods: We retrospectively analyzed data from patients with native, isolated aortic coarctation treated by surgical or endovascular methods between 2015 and 2024. Clinical and demographic data were collected from electronic health records. Blood pressure was measured using oscillometric devices, and transthoracic echocardiography (TTE) was performed by an experienced sonographer. The primary endpoint was to identify which treatment predicted re-coarctation during follow-up, while the secondary endpoint assessed the incidence of late arterial hypertension. Results: Sixty-nine patients were included, with a mean age of 18.14 ± 8.18 years (median 16 years; range 8 to 37 years) and a median follow-up of 3 years (range 6 months to 8 years). Of these, 67 (97.1%) underwent elective repairs. Repair techniques included endovascular treatment (24.6%), surgical end-to-end anastomosis (47.8%), and surgical patchplasty (27.5%). The endovascular group was significantly older (29.82 ± 5.9 years vs. 14.33 ± 4.25 years, p = 0.056) and had shorter procedure durations and hospital stays. One-year freedom from reintervention was significantly higher in the surgical group (98.7%) compared to the endovascular group (88.23%) (p < 0.001). Conclusions: Both techniques effectively treat aortic coarctation, but surgical repair offers better long-term outcomes, while endovascular repair provides shorter recovery times. These findings should inform the choice of treatment modality based on patient-specific factors and clinical priorities.