Surgical closure of patent ductus arteriosus in very-low-birth-weight infants

Abstract

In many very-low-birth-weight (VLBW) infants the ductus arteriosus fails to close spontaneously, and they subsequently develop signs and symptoms of poor tissue perfusion and heart failure. This study evalutes the results of early surgical closure of patent ductus arteriosus (PDA). We retrospectively reviewed the records of all 101 VLBW infants who weighed 1,500 g or less when their PDA was surgically ligated in Turku University Hospital between 1988 and 1998. The mean gestational age at birth was 27.2 weeks and mean birth weight 963+/-239 g. The operation was performed at 12+/-8 days of age; the infants' weight at operation was 969+/-231 g and they were tracheally extubated 11+/-14 days after the operation. The surgery-related mortality was 3% (3/101) and overall mortality 10% (10/101). We conclude that surgical closure of PDA is safe and effective in VLBW infants.

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

“…Thirty-two studies that satisfied the inclusion criteria were included in the analysis (Fig 1). OCEBM levels of evidence varied from level 3 (9 studies) [9][10][11][14][15][16]20,23,26 to level 4 (23 studies) [6][7][8]12,13,[17][18][19]21,22,24,25,[27][28][29][30][31][32][33][34][35][36][37] ( Table 1). Occurrence of UVFP, type of surgery, patient demographics, and vocal fold assessment are reported in Table 1.…”

“…7,8,[10][11][12][13][14][15]17,20,21,24,[27][28][29][30][31][34][35][36][37] The weighted pooled proportion was 8.7% (95% CI, 5.4% to 12.6%) (Fig 3). Heterogeneity analysis measured an I 2 of 81.6% (95% CI, 65.0% to 88.4%).…”

Acute Hemodynamic Decompensation Following Patent Ductus Arteriosus Ligation in Premature Infants

“…The postoperative mortality after PDA ligation that is directly attributable to the surgical procedure (ie, hemorrhage) is consistently reported to be approximately 1%-3% [9,[15][16][17]. However, overall mortality in premature infants after PDA ligation is significantly higher.…”

Patent ductus arteriosus ligation in premature infants: who really benefits, and at what cost?

“…Surgical ligation of PDA is considered standard treatment for symptomatic infants who do not respond to treatment with indomethacin. Since the first reported PDA ligation by Gross in 1938, numerous studies have shown PDA ligation to be both technically feasible and safe, even in premature, low-birth-weight infants [3][4][5][6][7][8].…”