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Short-Term Complications Associated with Surgical Ligation of Patent Ductus Arteriosus in ELBW Infants: A 25-Year
Megan Foster1, Lea H Mallett1, Vinayak Govande1
1Department of Pediatrics, Baylor Scott & White McLane Children's Medical Center, Temple, Texas.
Insights
Surgical patent ductus arteriosus (PDA) ligation in extremely low birth weight infants has a complication rate of 44%. Younger infants undergoing PDA repair face higher complication risks, but short-term issues did not impact long-term outcomes.
Area of Science:
- Neonatal surgery
- Pediatric cardiology
- Critical care medicine
Background:
- Patent ductus arteriosus (PDA) is a common condition in extremely low birth weight (ELBW) infants.
- Surgical ligation is a treatment option for PDA, but carries risks of short-term complications.
- The association between these complications and long-term outcomes in ELBW infants requires further investigation.
Purpose of the Study:
- To determine the incidence of short-term complications following surgical PDA ligation in ELBW infants.
- To identify factors associated with these short-term complications.
- To assess if short-term complications correlate with adverse long-term outcomes.
Main Methods:
- Retrospective cohort study of ELBW infants (<1,000g) undergoing surgical PDA ligation between 1989 and 2015.
- Review of demographic, clinical, and laboratory data.
- Primary outcome: short-term (<2 weeks) surgical complications; Secondary outcomes: bronchopulmonary dysplasia (BPD), length of stay, mortality.
Main Results:
- 180 ELBW infants were analyzed (median gestational age 24 weeks, birth weight 683g).
- 44% of infants experienced at least one short-term complication; common issues included vasopressor use (33%) and vocal cord paralysis (9%).
- Younger corrected gestational age at repair was linked to increased complication risk; however, mortality, length of stay, and BPD rates were similar regardless of complications.
Conclusions:
- Short-term complications from surgical PDA ligation in ELBW infants occur in a significant minority.
- Younger corrected gestational age is a risk factor for complications.
- Further research is necessary to establish a link between short-term complications and long-term adverse outcomes.
Objective:
This article aims to determine the incidence of short-term complications of surgical patent ductus arteriosus (PDA) ligations, the factors associated with those complications, and whether complications are associated with poor long-term outcomes.
Study Design:
Retrospective cohort study of all extremely low birth weight (ELBW, < 1,000 g) infants who underwent surgical PDA ligation at a single-center neonatal intensive care unit from 1989 to 2015. Demographic, clinical, and laboratory data were reviewed. The primary outcome was development of a short-term (< 2 weeks from ligation) surgical complication. Secondary outcomes include bronchopulmonary dysplasia (BPD), length of stay, and mortality.
Results:
A total of 180 ELBW infants were included; median gestational age and birth weight was 24 weeks and 683 g, respectively, and 44% of infants had at least one short-term complication. Need for vasopressors (33%) was the most common medical complication and vocal cord paralysis (9%) was the most common surgical complication. Younger corrected gestational age at time of repair was associated with increased risk for complications. Mortality, length of stay, and BPD rates were similar between infants with and without complications.
Conclusion:
Serious complications were seen in a minority of infants. Additional research is needed to determine if short-term complications are associated with long-term adverse outcomes.
