Primary Surgical Closure Should Be Considered in Premature Neonates with Large Patent Ductus Arteriosus

Ko, Seongmin; Yoon, Young Chul; Cho, Kwang-Hyun; Lee, Yang-Haeng; Han, Il-Yong; Park, Kyung-Taek; Hwang, Youn‐Ho; Jun, Hee Jae

doi:10.5090/kjtcs.2013.46.3.178

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…For PDA, current treatment requires cyclooxygenase (COX) inhibitor therapy (i.e., ibuprofen and/or indomethacin) and surgical intervention for approximately one‐third of cases that do not respond to COX inhibitors . PDA ligation represents a relatively safe procedure . We assume that optimal treatment reduces the mortality risks associated with heart defects to 1% at one year of age and 0.5% at age five years (including surgical risks) .…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of the Manifestations of Congenital Rubella Syndrome in Infants and Characterization of Disability‐Adjusted Life Years (DALYs)

et al. 2014

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Congenital rubella syndrome (CRS) continues to cause disability among unvaccinated populations in countries with no or insufficient rubella vaccine coverage to prevent transmission. We systematically reviewed the literature on birth outcomes associated with CRS to estimate the duration, severity, and frequency of combinations of morbidities. We searched PubMed, the Science Citation Index, and references from relevant articles for studies in English with primary data on the frequency of CRS manifestations for ≥20 cases and identified 65 studies representing 66 study populations that met our inclusion criteria. We abstracted available data on CRS cases with one or more hearing, heart, and/or eye defect following maternal rubella infection during the period of 0-20 weeks since the last menstrual period. We assessed the quality and weight of the available evidence using a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Most of the evidence originates from studies in developed countries of cohorts of infants identified with CRS in the 1960s and 1970s, prior to the development of standardized definitions for CRS and widespread use of vaccine. We developed estimates of undiscounted disability-adjusted life years (DALYs) lost per CRS case for countries of different income levels. The estimates ranged from approximately 19 to 39 for high-income countries assuming optimal treatment and from approximately 29 to 39 DALYs lost per CRS case in low- and lower- middle-income countries assuming minimal treatment, with the lower bound based on 2010 general global burden of disease disability weights and the upper bound based on 1990 age-specific and treatment-specific global burden of disease disability weights. Policymakers and analysts should appreciate the significant burden of disability caused by CRS as they evaluate opportunities to manage rubella.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of the Manifestations of Congenital Rubella Syndrome in Infants and Characterization of Disability‐Adjusted Life Years (DALYs)

et al. 2014

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“…However, there is no consensus on the first choice of treatment. [1][2][3] Medical agents such as intravenous (i.v.) or oral ibuprofen and i.v.…”

Section: Introductionmentioning

confidence: 99%

Bedside Surgery to Treat Patent Ductus Arteriosus in Low-Birth-Weight Premature Infants

Albayrak

Aykut

Karaçelik

et al. 2014

Open�J Cardiovasc Surg

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BACKGROUNDPatent ductus arteriosus (PDA) is commonly seen in premature infants with low birth weights (LBW). It is a condition that has high mortality and morbidity rates. Early closure of the ductus arteriosus may require surgery or medical treatment. However, the decision of first medical approach for symptomatic PDA closure is still debated. In this study, we compared the surgical and medical treatments for the closure of PDA in premature LBW infants.METHODSThis study included 27 premature infants whose birth weights were lower than 1500 g, who were born in the period between 2011 and 2013 and had symptomatic PDA. Patients were separated into two groups: groups A and B. Group A included patients whose PDAs were closed with medical treatment (n = 16), and group B included patients who had undergone surgical operations for PDA closure (n = 11).RESULTSThere were no statistically significant differences between groups A and B when the groups were compared in terms of birth weight, gestational age, respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), sepsis, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and pneumothorax. Although the mortality rate was determined to be lower in group B (2 out of 11, 18.1%) than in group A (7 out of 16, 43.7%), no statistically significant difference was found between the two groups. A statistically significant increase was determined in the incidence of kidney function loss in patient group that received Ibuprofen, a medical treatment, in comparison to the patients who had surgery.CONCLUSIONIn conclusion, surgery is a safe method to repair PDA in premature LBW infants. Although there is no remarkable difference between surgery and medical treatment, we suggest that a surgical approach may be used as a first choice to repair PDA considering the lower rate of mortality and morbidity and higher rate of closure compared to medical treatment.

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B-type Natriuretic Peptide: A Diagnostic Biomarker for a Hemodynamically Significant PDA

Zekri

Said

Hegazy

et al. 2022

Open Access Maced J Med Sci

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Background: B-type natriuretic peptide (BNP) it has been reported to be a useful biomarker for the severity of hemodynamically significant patent ductus arteriosus (HsPDA) in premature infants. Objective: To assess serum levels of BNP in premature neonates with echocardiographically-confirmed hemodynamically significant and non-significant PDA (HnsPDA) and to explore the effect of PDA on left ventricular function. We also aimed to detect the level of BNP that differentiates between HsPDA and HnsPDA. Patients and methods: This was a cross-sectional observational study conducted on 73 randomly selected preterm neonates with HsPDA or hemodynamically nonsignificant PDA (HnsPDA), between May 2017 and May 2018. Echocardiography was done. BNP was measured using enzyme linked immunosorbent assay Results: There was no affection of left ventricular function in either group (LA/Ao ratio, FS, LVESD and LVEDD). PDA size, PFO size and PAP were significantly larger in HsPDA (p<0.001, p=0.001, p<0.001 respectively). Levels of BNP were significantly higher in HsPDA and correlated with the size of the PDA. At a cut-off value of 160.5 pg/ml, BNP had 80.49% sensitivity and 90.62% specificity with a positive predictive value of 91.7% and a negative predictive value of 78.04%, (AUC: 0.923, 95% C.I. 0.837 to 0.973). Conclusion: Levels of BNP in preterm babies with hemodynamically significant PDA rise early in neonatal life and correlate well with the size of the PDA. BNP can be used to screen for this condition. Ventricular dysfunction may not appear in the first 3 days of life.

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Primary Surgical Closure Should Be Considered in Premature Neonates with Large Patent Ductus Arteriosus

Cited by 3 publications

References 17 publications

Systematic Review of the Manifestations of Congenital Rubella Syndrome in Infants and Characterization of Disability‐Adjusted Life Years (DALYs)

Systematic Review of the Manifestations of Congenital Rubella Syndrome in Infants and Characterization of Disability‐Adjusted Life Years (DALYs)

Bedside Surgery to Treat Patent Ductus Arteriosus in Low-Birth-Weight Premature Infants

B-type Natriuretic Peptide: A Diagnostic Biomarker for a Hemodynamically Significant PDA

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