Comparison of Cost and Clinical Outcome Between Transcatheter Coil Occlusion and Surgical Closure of Isolated Patent Ductus Arteriosus

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.

Download Full-text

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

Download Full-text

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.

Download Full-text