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[Indications for ligation of ductus arteriosus Botalli persistens in premature infants]
Insights
Surgical ligation of patent ductus arteriosus is a safe, life-saving procedure for premature infants. Medical treatment with prostaglandin inhibitors is an alternative in select cases, with varying outcomes.
Area of Science:
- Neonatal surgery
- Pediatric cardiology
- Pharmacology
Context:
- Patent ductus arteriosus (PDA) is a common condition in premature infants.
- PDA can lead to significant cardiorespiratory complications.
- Treatment options for PDA include medical management and surgical intervention.
Purpose:
- To evaluate the safety and efficacy of surgical ligation for PDA in premature infants.
- To compare outcomes of medical treatment (prostaglandin inhibitors) versus surgical intervention.
- To analyze mortality rates associated with different PDA treatment strategies.
Summary:
- A study of 215 premature infants treated for PDA between 1976-1985.
- 52 infants experienced spontaneous closure, 68 had closure after indomethacin treatment.
- 48 infants underwent surgery after medical therapy failure, and 53 were primarily operated due to contraindications to indomethacin.
- Overall mortality was 20%, highest in patients receiving combined medical and surgical treatment.
Impact:
- Surgical ligation of PDA is a viable and potentially life-saving option for premature infants.
- Medical management with prostaglandin inhibitors can be effective in selected cases.
- Combined medical and surgical approaches may be associated with higher mortality, necessitating careful treatment selection.
Abstract:
Ligation of patent ductus arteriosus can be safely performed even in the smallest prematures and may be life-saving. Medical treatment with prostaglandin-inhibitors may be substituted in selected cases. From 1976-1985 a total of 215 prematures was treated. 52 of those experienced spontaneous closure. In 68 infants closure occurred following indomethacin-treatment. 48 had operation after failure of medical therapy and 53 with contraindications to indomethacin were primarily operated. The overall mortality reached 20% and was highest among those with combined medical and surgical treatment.