Aortic Coarctation With Type B Aortic Dissection: A Systematic Review and Report of 2 Cases.

Abstract

Purpose: A systematic review of patients with aortic coarctation (CoA) and concomitant type B aortic dissection (TBAD) is presented; additionally, 2 cases of our own experience are reported.

Materials and methods: Following the PRISMA guidelines, databases were search for all articles or abstracts written in English published until May 2024. Mesh terms used included "aortic coarctation" in combination with "aortic dissection," "type B aortic dissection," and "TBAD."

Results: A total of 121 studies were screened, 19 full-length articles, and 1 abstract were included for analysis. Adding our own 2, a total of 22 cases were analyzed. The median age was 39 years (range: 25-64 years). Eighteen (81.8%) patients were male. Fourteen (63.6%) patients underwent open surgery. One (4.5%) patient underwent hybrid repair. Five (22.7%) patients underwent endovascular repair, including these 2 cases. Two (9%) patients were managed conservatively. The complication rate was 9% (n=2). There were no reported deaths, and the median follow-up period was 11.5 months (range: 6-48 months).

Conclusion: The most comprehensive data on patients with CoA and TBAD is presented. The pathophysiology of this disorder remains uncertain. Both endovascular and open surgery have proven effective in treating these conditions with low complication rates. However, long-term outcomes remain undefined.Clinical ImpactThis systematic review provides the most comprehensive analysis of patients with concomitant aortic coarctation and type B aortic dissection to date, offering valuable insights into the demographics, treatment strategies, and outcomes of this rare condition. The findings suggest that both open and endovascular repair are viable treatment options with low complication rates. The absence of mortality in the analyzed cases highlights the feasibility of surgical intervention. However, with limited long-term follow-up, the durability of these treatments remains uncertain, emphasizing the need for further research to guide optimal management and improve long-term patient outcomes.