Related Experiment Videos
Surgical closure of patent ductus arteriosus in 268 preterm infants
Insights
Surgical ligation is a safe and effective treatment for premature infants with patent ductus arteriosus. This procedure demonstrated low operative mortality and manageable postoperative complications in a collaborative study.
Area of Science:
- Neonatal surgery
- Pediatric cardiology
- Critical care medicine
Background:
- Patent ductus arteriosus (PDA) is a common condition in premature infants.
- Hemodynamically significant PDA can lead to severe complications.
- Previous management strategies included pharmacologic treatment with indomethacin.
Purpose of the Study:
- To evaluate the safety and efficacy of surgical ligation for patent ductus arteriosus in premature infants.
- To assess the outcomes of surgical intervention in a collaborative study setting.
Main Methods:
- A collaborative study involving 13 centers.
- 268 premature infants with birth weight < 1,750 gm underwent surgical ligation for PDA.
- Data collected over a 2-year period ending April 1981.
Main Results:
- No intraoperative deaths occurred; 3% mortality within 36 hours post-operation.
- Hospital mortality was 23%, with few deaths directly attributable to surgery.
- Postoperative morbidity (e.g., bronchopulmonary dysplasia, pneumothorax, sepsis) was not linked to birth weight, age, or preoperative indomethacin use.
Conclusions:
- Surgical ligation is a safe and effective procedure for managing patent ductus arteriosus in small premature infants.
- The intervention effectively addresses large left-to-right shunting.
- Outcomes were favorable despite the high-risk population.
Abstract:
Over a 2 year period ending in April, 1981, 268 premature infants with birth weight below 1,750 gm underwent operation for a "hemodynamically significant" patent ductus arteriosus. Operations were performed in 13 centers participating in a collaborative study, which was primarily designed to evaluate the role of indomethacin in the management of patent ductus arteriosus. No patient died during the operations, which were done at a median age of 10 days. Eight infants (3%) died within 36 hours after operation. In only one was the death directly attributable to the operative procedure. Hospital mortality (23%) and postoperative morbidity, which included bronchopulmonary dysplasia, pneumothorax, and sepsis, were unrelated to birth weight, age at operation, and degree of preexisting pulmonary disease or preoperative treatment of the infant with indomethacin. Results indicate that surgical ligation is a safe and effective procedure for treating patent ductus arteriosus with large left-to-right shunting in small premature infants.