Catheterization Therapy vs Surgical Closure in Pediatric Patients With Patent Ductus Arteriosus: A Meta-Analysis

AbstractDuctus arteriosus is an essential component of fetal circulation. Due to occurring changes in the cardiopulmonary system physiology after birth, ductus arteriosus closes. Patent ductus arteriosus can be closed by medical or invasive (percutaneous or surgical) treatment methods. Percutaneous or surgical closure of patent ductus arteriosus can be performed for the cases that medical closure failed. Surgical treatment is often preferred method for closure of patent ductus arteriosus in the neonatal period. The most common surgical complications are pneumothorax, recurrent laryngeal nerve injury, bleeding, and recanalisation. A very rare surgical complication is left pulmonary artery ligation that has been presented in a few cases in the literature. Echocardiography control should be performed in the early post-operative period, especially in patients with clinical suspicion. If reoperation is required, it should never be delayed. We report a newborn patient whose left pulmonary artery ligated accidentally during patent ductus arteriosus closure surgery and surgical correction of this complication at the early post-operative period.

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SURGICAL CLOSURE OF ATYPICAL PATENT DUCTUS ARTERIOSUS

Journal of Thoracic Surgery ◽

10.1016/s0096-5588(20)30930-2 ◽

1956 ◽

Vol 31 (3) ◽

pp. 332-337

Author(s):

N.A. Antonius ◽

L.G. Massarelli ◽

A.D. Crecca

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Surgical Closure ◽

Patent Ductus

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

American Journal of Perinatology Reports ◽

10.1055/s-0037-1615260 ◽

2017 ◽

Vol 07 (04) ◽

pp. e230-e233 ◽

Cited By ~ 1

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.

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STUDIES OF THE PULMONARY AND SYSTEMIC ARTERIAL PRESSURE IN CASES OF PATENT DUCTUS ARTERIOSUS WITH SPECIAL REFERENCE TO EFFECTS OF SURGICAL CLOSURE 1

Journal of Clinical Investigation ◽

10.1172/jci102312 ◽

1950 ◽

Vol 29 (6) ◽

pp. 745-753 ◽

Cited By ~ 14

Author(s):

Bowen E. Taylor ◽

Albert A. Pollack ◽

Howard B. Burchell ◽

O. Theron Clagett ◽

Earl H. Wood

Keyword(s):

Arterial Pressure ◽

Patent Ductus Arteriosus ◽

Special Reference ◽

Ductus Arteriosus ◽

Systemic Arterial Pressure ◽

Surgical Closure ◽

Patent Ductus

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Paracetamol versus Ibuprofen in the Closure of Patent Ductus Arteriosus: Proportion and Intervention Comparison Meta - Analysis

Pediatric Oncall ◽

10.7199/ped.oncall.2018.29 ◽

2018 ◽

Vol 15 (3) ◽

Author(s):

Mohammad Kamrul Hassan Shabuj ◽

Jesmin Hossain

Keyword(s):

Patent Ductus Arteriosus ◽

Meta Analysis ◽

Ductus Arteriosus ◽

Patent Ductus

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Meta-Analysis to Assess Efficacy and Safety of High-Dose Ibuprofen Compared with Standard Treatment of Patent Ductus Arteriosus in Premature Infants

Iranian Journal of Pediatrics ◽

10.5812/ijp.6328 ◽

2016 ◽

Vol 27 (4) ◽

Author(s):

Jinmiao Lu ◽

Jing Li ◽

Qin Li ◽

Zhiping Li

Keyword(s):

Patent Ductus Arteriosus ◽

Premature Infants ◽

Standard Treatment ◽

Meta Analysis ◽

Ductus Arteriosus ◽

High Dose ◽

Efficacy And Safety ◽

Patent Ductus

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Abstract 15358: Cardiac Remodeling in Adults Following Percutaneous Patent Ductus Arteriosus Closure: A Meta-analysis

Circulation ◽

10.1161/circ.142.suppl_3.15358 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sarah Blissett ◽

Harsh Agrawal ◽

Ahmed Kheiwa ◽

Hope Caughron ◽

Ian Harris ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Cardiac Remodeling ◽

Meta Analysis ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Reverse Remodeling ◽

Weighted Mean ◽

Post Procedure ◽

Patent Ductus

Introduction: Patent ductus arteriosus (PDA) is often recognized and treated with percutaneous closure in adults. However, the impact on cardiac reverse remodeling following PDA closure in adults is not clear. We performed a meta-analysis to characterize the extent of cardiac remodeling following percutaneous PDA closure in adults. Methods: MEDLINE and EMBASE were systematically searched for original studies that reported echocardiographic variables at baseline, immediately post-procedure (within 24 hours), and at follow-up (>1 month) in adults undergoing percutaneous PDA closure. Additionally, we included echocardiographic data from a cohort of patients >18 years of age that underwent percutaneous PDA closure between 01/2015 and 12/2019 at our centre. For parameters with sufficient data for pooling, weighted averages were calculated, and pooled differences were presented as weighted mean differences. Heterogeneity was assessed using the I 2 statistic. Results: After screening 278 abstracts, 5 studies were identified. When combined with our own cohort of 13 patients, our meta-analysis encompassed 244 patients. The weighted mean age of all patients was 33 years with all studies predominantly comprised of female patients and the median follow-up was 12 months (ranging from 1 month- 5 years across the studies). When compared to baseline, left ventricular ejection fraction (LVEF) decreased significantly immediately post-procedure and all parameters significantly decreased at follow-up (Table 1). Conclusions: As demonstrated by the decreases in the left ventricular and left atrial sizes, reverse remodeling was observed in adults who underwent percutaneous PDA closure. The significantly lower LVEF immediately post-procedure could reflect withdrawal of chronic volume overload or increased afterload. The clinical significance of the statistically significant lower LVEF on follow-up testing is unclear and requires further evaluation.

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