Percutaneous closure of a large patent ductus arteriosus in a preterm newborn weighing 1400 g without using arterial sheath: an innovative technique

2017 ◽  
Vol 28 (3) ◽  
pp. 494-497 ◽  
Author(s):  
Gaurav Garg ◽  
Vishal Garg ◽  
Amit Prakash
Keyword(s):  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Arterial Injury ◽  
Percutaneous Closure ◽  
Device Closure ◽  
Low Birth Weight Infants ◽  
Surgical Ligation ◽  
Innovative Technique ◽  
Patent Ductus

AbstractPercutaneous closure of patent ductus arteriosus is well established in infants weighing >5 kg, but data regarding outcome of preterm especially very low birth weight infants is minimal. Although surgical ligation of patent ductus arteriosus is the preferred and well-accepted modality of treatment after failure of drug therapy in preterm infants, it has also got its own demerits in such a small and fragile subset. Device closure in infants weighing <1.5 kg is rarely attempted because of high chances of complications, especially acute arterial injury due to the arterial sheath. We received a 1.4-kg ventilator-dependent infant for closure of large patent ductus arteriosus. Percutaneous closure of patent ductus arteriosus was done successfully and the infant was discharged on room air with a weight of 1.8 kg. We present here an innovative technique in which successful patent ductus arteriosus device closure was done in a 1.4-kg infant without using arterial sheath.

Indomethacin Therapy for Large Patent Ductus Arteriosus in the Very Low Birth Weight Infant: Results and Complications

PEDIATRICS ◽  
1979 ◽  
Vol 64 (2) ◽  
pp. 154-159
Author(s):  
H. L. Halliday ◽  
T. Hirata ◽  
J. P. Brady
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Base Deficit ◽  
Low Birth Weight Infants ◽  
Low Birth Weight Infant ◽  
Surgical Ligation ◽  
Patent Ductus

Of 36 very low birth weight infants (&lt;1,500 gm) with large patent ductus arteriosus, 24 (67%) showed satisfactory constriction or closure after indomethacin therapy (mean total dose 0.4 mg/kg). Twelve infants (33%) responded inadequately with seven infants requiring surgical ligation. Response was better in infants 8 to 14 days old compared to those more than 14 days old (89% vs 33%, P = .048) irrespective of birth weight or gestational age. Major complications were renal and unrelated to ductus response. Urine output fell significantly (3.65 to 1.63 ml/kg/hr, P &lt; .001) and in 47% of infants serum creatinine increased ≥1.5 mg/dl. Creatinine was less likely to rise in infants more than 14 days old. Hyponatremia was found in 36% of infants. Serum potassium increased more frequently in infants more than 8 days old and was &gt;6.0 mEq/liter in 25%. Indomethacin caused a reduction in PaCO2 (41 to 37 mm Hg, P &lt; .01) and an increase in pH (7.32 to 7.36, P &lt; .02) with no change in base deficit. These changes occurred even in the absence of clinical ductus closure. No other side effects of indomethacin therapy were noted. Three infants died but death was unrelated to indomethacin therapy. Overall survival was 92%, and nine infants (25%) developed mild bronchopulmonary dysplasia.

scholarly journals Surgical ligation of patent ductus arteriosus in very low birth weight infants: A 9-year single center experience

2020 ◽  
Author(s):  
Jun Ho Lee ◽  
Hyun Ju Lee ◽  
Hyun-Kyung Park ◽  
Ja-Hye Ahn ◽  
Hee Sun Kim ◽  
...  
Keyword(s):  
Birth Weight ◽  
Surgical Treatment ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Low Birth Weight Infants ◽  
Surgical Ligation ◽  
Patent Ductus

Abstract Background We analyzed the feasibility and outcomes of early surgical ligation in very low birth weight infants (VLBWIs) with hemodynamically significant patent ductus arteriosus (HSPDA) and investigated predictors for surgical treatment after unsuccessful medical management. Methods Medical records from the neonatal intensive care unit of Hanyang University Seoul Hospital from January 2010 to December 2018 were retrospectively reviewed. 233 VLBWIs with HSPDA were enrolled in our study. Of these infants, 134 underwent surgical ligation and were subdivided into the early ligation group (n = 49; within 10 days of age) and the late ligation group (n = 85; after 10 days of age). Results The mean gestational age and birth weight were significantly lower in the patent ductus arteriosus (PDA) ligation group than in the Non-ligation group (p < 0.001). PDA ductal diameter > 2.0 mm (p < 0.001), low Apgar score at 5 minutes (p = 0.033), and chorioamnionitis (p = 0.037) were the predictors for receiving surgical treatment for PDA. Early ligation was significantly associated with a low incidence of culture-proven sepsis (p = 0.004), mechanical ventilator time > 4 weeks (p = 0.007), necrotizing enterocolitis stage (NEC) ≥ III (p = 0.022), and intraventricular hemorrhage (IVH) grade ≥ III (p = 0.035). Conclusions Early surgical ligation minimizes adverse effects of HSPDA in predicted infants who subsequently require surgical treatment for PDA. We suggest that predicted VLBWIs with HSPDA that is unresponsive to medical treatment should avoid delayed ductal closure to reduce severe NEC, severe IVH, culture-proven sepsis, and facilitate earlier endotracheal extubation.

scholarly journals MANAGEMENT OF HYPERTENSIVE PDA

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S701-05
Author(s):  
Khushal Khan Khattak ◽  
Maad Ullah ◽  
Abdul Malik Sheikh ◽  
Asma Kanwal ◽  
Sajid Ali Shah ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Palliative Treatment ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Device Closure ◽  
Surgical Ligation ◽  
Percutaneous Catheter ◽  
Patent Ductus

Objective: To determine different treatment options in patients of Patent Ductus Arteriosus with pulmonary hypertension beyond neonatal period. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was carried out in Pediatric Cardiology department of Rawalpindi Institute of Cardiology, from Jan 2017 to Jan 2019. Methodology: Patients having PDA with pulmonary hypertension were included in the study. Treatment options were divided into percutaneous catheter device closure, surgical ligation of patent ductus arteriosus and palliative treatment. Any adverse event during the procedure was documented. Stratification was done in regard to gender and age group. Post stratification chi square test was applied and p-value less than or equal to 0.05 was considered as significant. Results: Total number of patients included in the study were 37. Mean age (years) of patients (Mean ± SD) was 19.21 ± 8.76. Mean ± SD pulmonary artery pressure was 56.43 ± 11.55 mmHg. Percutaneous catheter device closure was successful in 24 (64.9%) patients, in 7 (18.9%) patients primary surgical PDA ligation was done, 3 (8.1%) patients were advised palliative treatment and in 3 (8.1%) patients adverse events occurred during percutaneous device closure and were thus referred for surgical ligation. Patent ductus Arteriosus Occlutech device was used in 18 (48.6%) patients, Occlutech VSD device was used in 7 (18.5%) patients and in 1 (2.7%) patient AGA duct occluder was used. Conclusion: In patients with patent ductus arteriosus and pulmonary artery hypertension, percutaneous catheter device closure is a safe and effective procedure.

scholarly journals Urinary acute kidney injury biomarkers in very low-birth-weight infants on indomethacin for patent ductus arteriosus

2019 ◽  
Vol 85 (5) ◽  
pp. 678-686 ◽  
Author(s):  
Sina Waldherr ◽  
Alexander Fichtner ◽  
Bernd Beedgen ◽  
Thomas Bruckner ◽  
Franz Schaefer ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Kidney Injury ◽  
Low Birth Weight Infants ◽  
Patent Ductus

Urinary NT-proBNP, NGAL, and H-FABP May Predict Hemodynamic Relevance of Patent Ductus Arteriosus in Very Low Birth Weight Infants

Neonatology ◽  
2012 ◽  
Vol 101 (4) ◽  
pp. 260-266 ◽  
Author(s):  
Veronika Tosse ◽  
Frank Pillekamp ◽  
Pablo Verde ◽  
Berit Hadzik ◽  
Hemmen Sabir ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Low Birth Weight Infants ◽  
Patent Ductus
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