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Management of patent ductus arteriosus: a comparison of operative v pharmacologic treatment

S B Palder1, M Z Schwartz, K R Tyson

  • 1Department of Surgery, University of California, Davis Medical Center, Sacramento 95817.

Journal of Pediatric Surgery
|December 1, 1987
PubMed

Insights

Surgical ligation offers predictable results for premature infants with patent ductus arteriosus (PDA). This method shows low morbidity and no mortality, making it the preferred treatment for infants under 800g.

Area of Science:

  • Neonatalogy
  • Pediatric Cardiology
  • Surgical Innovation

Background:

  • Patent ductus arteriosus (PDA) is a common condition in premature infants.
  • Hemodynamically significant PDA can lead to cardiopulmonary compromise.
  • Treatment options include pharmacologic and surgical interventions.

Purpose of the Study:

  • To compare the efficacy and outcomes of surgical ligation versus indomethacin for hemodynamically significant PDA in premature infants.
  • To determine the preferred treatment modality for low-birth-weight premature infants.

Main Methods:

  • Retrospective review of 183 premature infants with hemodynamically significant PDA over a 5-year period.
  • Infants were treated with either surgical ligation (107) or indomethacin (76).
  • Outcomes including treatment failure, complications, and mortality were analyzed.

Main Results:

  • Surgical ligation had no treatment failures and one complication.
  • Indomethacin therapy failed in 42% of infants, with 84% requiring subsequent surgery.
  • Infants who failed indomethacin generally had lower birth weights, shorter gestations, and required prolonged ventilation.
  • No deaths were directly attributable to either treatment modality.

Conclusions:

  • Surgical ligation of PDA provides predictable outcomes with low morbidity and no mortality.
  • Surgical ligation is the preferred treatment for premature infants weighing less than 800 grams.
  • Indomethacin therapy has a significant failure rate, often necessitating surgical intervention.

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