Minimally Invasive Surgical Closure of Patent Ductus Arteriosus in Premature Infants: A Novel Approach

2010 ◽  
Vol 17 (4) ◽  
pp. 292-294 ◽  
Author(s):  
Ennio Mazzera ◽  
Gianluca Brancaccio ◽  
Cristiana Feltri ◽  
Guido Michielon ◽  
Roberto Di Donato
Keyword(s):  
Minimally Invasive ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Surgical Closure ◽  
Minimally Invasive Surgical ◽  
Novel Approach ◽  
Patent Ductus

scholarly journals Low-Dose Intravenous Paracetamol for Patent Ductus Arteriosus in Indomethacin-Resistant or Contraindicated Preterm Infants: Three Cases Reports

2017 ◽  
Vol 07 (04) ◽  
pp. e230-e233 ◽  
Author(s):  
Shun Matsumura ◽  
Ayumi Oshima ◽  
Sumie Fujinuma ◽  
Kosuke Tanaka ◽  
Nobuhiko Nagano ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Limited Data ◽  
Gastrointestinal Complications ◽  
Surgical Closure ◽  
Institutional Ethics ◽  
Intravenous Paracetamol ◽  
Administration Protocol ◽  
Patent Ductus

Background Although indomethacin (IND) is the standard treatment for hemodynamically significant patent ductus arteriosus (hsPDA) in Japan, it may be associated with renal impairment and gastrointestinal complications. The use of paracetamol for hsPDA closure has recently increased. Unlike IND, paracetamol does not have a peripheral vasoconstrictive effect and can be given to infants with contraindications to IND. Based on limited data available from randomized trials, paracetamol and IND seem to have similar effects. However, there have been no reports of the use of paracetamol for hsPDA in Japan. Cases Our drug administration protocol was approved by the institutional ethics committee after purchasing a clinical trial insurance. In three premature infants in whom IND was contraindicated or ineffective, a 7.5 mg/kg of paracetamol was intravenously administered every 6 hour for 3 days after obtaining parental consents. A temporary hsPDA closure was observed in two of the three infants. However, all three infants eventually needed surgical closure. No side effects, such as hepatic and renal dysfunctions, and adverse events were reported. Conclusion The intravenous administration of paracetamol was safe and feasible in premature infants with hsPDA. Future clinical trials with optimized dose and timing of administration are needed.

Consequences of Delayed Surgical Closure of Patent Ductus Arteriosus in Very Premature Infants

2006 ◽  
Vol 81 (1) ◽  
pp. 231-234 ◽  
Author(s):  
Sophie Jaillard ◽  
Benoît Larrue ◽  
Thameur Rakza ◽  
Eric Magnenant ◽  
Henri Warembourg ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Surgical Closure ◽  
Very Premature Infants ◽  
Patent Ductus

Surgical closure of patent ductus arteriosus in premature infants

1975 ◽  
Vol 35 (1) ◽  
pp. 165
Author(s):  
Edward A. Rittenhouse ◽  
Donald B. Doty ◽  
Ronald M. Lauer ◽  
Johann L. Ehrenhaft
Keyword(s):  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Surgical Closure ◽  
Patent Ductus

scholarly journals Safety and Feasibility of Intravenous Paracetamol for Patent Ductus Arteriosus in Indomethacin-/Ibuprofen-Resistant or -Contraindicated Preterm Infants: A Case Series

2020 ◽  
Vol 10 (01) ◽  
pp. e49-e53
Author(s):  
Ayumi Oshima ◽  
Shun Matsumura ◽  
Ayaka Iwatani ◽  
Machiko Morita ◽  
Sumie Fujinuma ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Case Series ◽  
High Plasma ◽  
Gastrointestinal Complications ◽  
Surgical Closure ◽  
Intravenous Paracetamol ◽  
Patent Ductus

Abstract Background Although indomethacin and ibuprofen are the standard treatments for hemodynamically significant patent ductus arteriosus (hsPDA), they are associated with renal impairment and gastrointestinal complications. Paracetamol for hsPDA closure does not provoke a peripheral vasoconstrictive effect and seems to have effects similar to those of indomethacin and ibuprofen. We have previously reported the safety of low-dose (7.5 mg/kg) intravenous paracetamol for preterm infants with hsPDA, who were indomethacin-resistant or -contraindicated but did not affect the need for surgical PDA ligation. However, reports considering the use of higher-dose (15 mg/kg) paracetamol for hsPDA have not been published in Japan. Cases In 16 premature infants in whom indomethacin or ibuprofen was contraindicated or ineffective, 15 mg/kg of paracetamol was intravenously administered every 6 hours for 3 days after obtaining parental consent. hsPDA closure or narrowing was observed in 14 infants (88%), with the need for surgical closure totally avoided in nine cases (56%). High plasma paracetamol levels were observed in three cases. No paracetamol-related side effects or adverse events were reported. Conclusion The intravenous administration of higher dose paracetamol was safe and feasible in premature infants with hsPDA. Future clinical trials to explore the optimized dose and timing of administration are needed.

The Impact of Surgical Patent Ductus Arteriosus Closure on Autonomic Function in Premature Infants

2017 ◽  
Vol 34 (09) ◽  
pp. 874-878
Author(s):  
Marina Metzler ◽  
Vedavalli Govindan ◽  
Tareq Al-Shargabi ◽  
Dilip Nath ◽  
Anita Krishnan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Fluctuation Analysis ◽  
Surgical Closure ◽  
Before And After ◽  
The Impact ◽  
Detrended Fluctuation ◽  
Patent Ductus

Background Patent ductus arteriosus (PDA) is a common complication of prematurity and a risk factor for poor outcome. Infants undergoing surgical PDA ligation are at highest risk for neurodevelopmental injury. Autonomic dysfunction has been described in premature infants with PDA. Aim To interrogate the autonomic nervous system by analysis of advanced heart rate variability (HRV) metrics before and after surgical closure of the PDA. Study Design Prospective, observational study. Subjects Twenty-seven infants born before 28 weeks' gestation were included in this study. Methods Continuous electrocardiogram data were sampled at a rate of 125 Hz for a total of 6 hours before and 6 hours after 30 hours of surgical closure. HRV was determined by detrended fluctuation analysis to calculate the short and long root mean square (RMSL and RMSS) and α components at two time scales (long and short). Results Gestational age (GA) was positively associated with RMSL, RMSS, and αS and was negatively associated with αL. There was no difference between RMSs, RMSL, αS, or αL before and after surgery; however, median heart rate was lower after surgery (p < 0.01). Conclusion Advancing GA is highly associated with increasing HRV; however, surgical ligation does not affect HRV in the postoperative period.

Thoracic sequelae after surgical closure of the patent ductus arteriosus in premature infants

1997 ◽  
Vol 86 (2) ◽  
pp. 213-216 ◽  
Author(s):  
M-C Seghaye ◽  
RG Grabitz ◽  
G Alzen ◽  
F Trommer ◽  
H Hörnchen ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Surgical Closure ◽  
Patent Ductus

scholarly journals SCENARIOS OF THE COURSE OF BRONCHOPULMONARY DYSPLASIA IN PREMATURE INFANTS WITH PATENT DUCTUS ARTERIOSUS IN FOLLOW-UP TO 3 YEARS

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 15-20
Author(s):  
Y. Sorokolat ◽  
T. Klimenko ◽  
O. Karapetian ◽  
O. Kalutska
Keyword(s):  
Patent Ductus Arteriosus ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Neonatal Period ◽  
Ductus Arteriosus ◽  
Surgical Closure ◽  
Group I ◽  
Perinatal Center ◽  
Patent Ductus

Summary. Bronchopulmonary dysplasia (BPD) is one of the most common long-term complications associated with preterm birth. The severity of BPD is associated with immaturity of a child's body, perinatal infections, and patent ductus arteriosus (PDA).The aim of the study was to identify the features of BPD in the 1st year of life of a child and in the follow- up to 3 years, depending on the condition of the ductus arteriosus.Material and methods. The observations of 146 premature infants with BPD, who were divided into groups depending on the state of the ductus arteriosus, were analyzed: Group I consisted of 58 children with BPD whose ductus arteriosus closed spontaneously in the early neonatal period; II group – 60 children with hemodynamically insignificant PDA, which remained open for 6-12 months; III group – 28 children with hemodynamically significant (HS) PDA, which required surgical closure during the stay of a child in the perinatal center. Results. There were significantly more cases of severe BPD among children of group II compared to group I: 23.3 vs. 8.6 % (p <0.01) and, accordingly, fewer cases of moderate course: 41.7 vs. 58.6 % (p <0.05) at the stage of children treatment in the perinatal center. At the age of 3 years, there were significantly more healthy children who underwent BPD in group I compared to group III: 62.5 vs. 25.9 % (p <0.01), and severe course was significantly more common in both groups II and III compared to group I: 6.8 and 7.4 % vs. 0 % (p <0.01). No significant differences in the severity of BPD at the age of 2-3 months and in the follow-up to 1 year from the date of surgical closure of HS PDA were detected. Conclusions. Sexual dimorphism was found, namely the prevalence of males among preterm infants with delayed closure of the ductus arteriosus. The presence of hemodynamic disorders connected with PDA is associated with a more severe course of BPD at the age of 3 years compared to children whose ductus arteriosus closed on its own in the early neonatal period. At the average term of surgical closure of PDA 21.5 ± 1.6 days of life, significant differences in the severity of BPD from the term of surgical closure of PDA weren`t detected.

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