scholarly journals Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Marien Lenoir ◽  
Chloé Wanert ◽  
Damien Bonnet ◽  
Mathilde Méot ◽  
Barthélémy Tosello ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Renal Vein Thrombosis ◽  
Morbidity And Mortality ◽  
Very Preterm Infants ◽  
Minimally Invasive Surgical ◽  
Surgical Group ◽  
Patent Ductus

Introduction: Patent ductus arteriosus (PDA) is common in preterm infants and contributes to morbidity and mortality. Several studies have shown the feasibility and safety of percutaneous PDA closure. Minimally invasive surgical ligation by anterior thoracotomy is an alternative, bedside technique for PDA closure in very low birth weight preterm infants. Our study aimed to compare short- and medium-term morbidity and mortality between anterior minithoracotomy and transcatheter PDA closure.Methods: From 2010 to 2020, 92 preterm infants <1,600 g underwent PDA closure in two centers: 44 surgical anterior minithoracotomies (center 1) and 48 transcatheter closures (center 2). Using a 1:1 propensity score match analysis, 22 patients in each group were included. The primary outcome was time to extubation after intervention.Results: Preoperative characteristics were similar in both groups after propensity matching (mean weight at procedure, 1,171 ± 183 g; p = 0.8). Mean time to extubation was similar: 10 ± 15 days in the surgical group vs. 9 ± 13 days in the transcatheter group (p = 0.9). Mean age at hospital discharge was 114 ± 29 days vs. 105 ± 19 days (p = 0.2). Two deaths occurred in the surgical group and one in the transcatheter group (p = 0.61). Five complications (pneumothorax n = 2, chylothorax n = 2, phrenic nerve injury n = 1) occurred in three patients after surgery. Three complications (chylothorax n = 1, endocarditis n = 1, renal vein thrombosis n = 1) occurred in two patients after percutaneous closure (p = 0.63).Conclusion: Equivalent efficiency and safety of surgical mini-invasive vs. transcatheter PDA closure in preterm infants <1,600 g are in favor of applying these alternative techniques according to centers' facilities and competences.

scholarly journals Patent ductus arteriosus, systemic NT-proBNP concentrations and development of bronchopulmonary dysplasia in very preterm infants: retrospective data analysis from a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomiia Potsiurko ◽  
Dmytro Dobryanskyy ◽  
Lesya Sekretar
Keyword(s):  
Randomized Controlled Trial ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Roc Curve ◽  
Controlled Trial ◽  
Ductus Arteriosus ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Randomized Controlled ◽  
Patent Ductus

Abstract Background Patent ductus arteriosus (PDA) is a common complication in very preterm infants. It is known that there is an association between PDA and development of bronchopulmonary dysplasia (BPD) or death before the postmenstrual age (PMA) of 36 weeks, but this association remains one of the most controversial aspects of the problem. The study aimed to evaluate the relationship between PDA, serum NT-proBNP levels at 2–3 and 8–9 days of life, and BPD/death in very preterm infants. Methods Data of 52 preterm infants with a gestational age < 32 weeks, chronological age < 72 h, and PDA diameter > 1.5 mm, enrolled in a randomized controlled trial, were used for the retrospective analysis. All patients underwent daily echocardiographic and two serum NT-proBNP measurements within the first 10 days after birth. Two groups of infants were formed retrospectively at PMA of 36 weeks depending on the outcome, BPD (n = 18)/death (n = 7) or survival without BPD (n = 27). Receiver operator characteristic (ROC) curve was used to evaluate the predictive performance of serum NT-proBNP levels for BPD/death occurrence. Results The percentage of infants who received pharmacological treatment for PDA did not differ between the groups. Based on the area under the ROC curve, serum NT-proBNP levels on the 2–3 day of life (AUC = 0.71; 95% confidence interval (CI): 0.56–0.9; p = 0.014)) and on the 8–9 day of life (AUC = 0.76; 95% CI: 0.6–0.9; p = 0.002) could reliably predict BPD/death in very preterm infants who had PDA diameter > 1.5 mm in the first 72 h of life. Hemodynamically significant PDA (hsPDA) was significantly more often detected in newborns with BPD/death, however, treatment of infants with hsPDA did not reduce the incidence of BPD/death. Conclusions In very preterm infants with PDA > 1.5 mm at the age of 24–48 h, serum NT-proBNP concentration could reliably predict the development of BPD or death, regardless of the persistence of PDA, with the highest diagnostic value at 8–9 days. Trial registration This study is registered in ClinicalTrials.gov - NCT03860428 on March 4, 2019.

Anterior mini-thoracotomy versus transcatheter closure of patent ductus arteriosus in very preterm infants

2021 ◽  
Vol 13 (4) ◽  
pp. 282-283
Author(s):  
Chloé Wanert ◽  
Marien Lenoir ◽  
Damien Bonnet ◽  
Mathilde Meot ◽  
Virginie Fouilloux ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Mini Thoracotomy ◽  
Patent Ductus

scholarly journals Ibuprofen treatment for patent ductus arteriosus in preterm infants: a retrospective cohort study in a leading Chinese center

2021 ◽  
Vol 1 (2) ◽  
pp. 103-110
Author(s):  
Jia Chen ◽  
Jinghua Luo ◽  
Hao Liu ◽  
Xue Du ◽  
Shan Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Group ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Retrospective Cohort ◽  
Ductus Arteriosus ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Patent Ductus

Abstract Objective There is a dilemma of ibuprofen treatment with patent ductus arteriosus (PDA) as to how and when to treat. We aimed to clarify this issue in very preterm infants (VPIs; < 32 weeks). Methods This retrospective study included 1 659 VPIs who were diagnosed with PDA according to echocardiographic examinations and cardiovascular dysfunction scoring system (the CVD scoring). The VPIs were classified into six groups (A1, A2, A3, B1, B2, and B3) based on CVD scores (A, < 3, and B, ≥ 3), and treatment with ibuprofen for PDA (1, conservational management; 2, early ibuprofen treatment; and 3, late ibuprofen treatment). Treatment was stopped when PDA was closed, CVD score was zero or PDA needed ligation. Results VPIs with CVD scores < 3 had most PDA closure without surgery, and early ibuprofen treatment did not significantly affect PDA closure. VPIs with CVD scores ≥ 3 had some PDA closure after 2 courses of treatment, but closure rates decreased linearly with ibuprofen course (1st 75.2%, 2nd 62.3%, 3rd 50.0%, P < 0.0001), and early ibuprofen treatment (group B2) did not increase PDA closure compared to late ibuprofen treatment (group B3). In these same infants, the longer they were in CVD scores ≥ 3, the more the complications of preterm were increased (retinopathy of prematurity ROP 1st 16.5%, 2nd 23.8%, 3rd 29.6%, P = 0.016; bronchopulmonary dysplasia BPD 1st 15.5%, 2nd 26.7%, 3rd 33.8%, P < 0.0001; intraventricular hemorrhage IVH 1st 20.4%, 2nd 32.4%, 3rd 23.8%, P = 0.015). Conclusion Ibuprofen is suggested for PDA closure when the PDA reopens or has developed into the stage when the CVD score ≥ 3.

Neurodevelopmental Outcome at 2 Years of Age according to Patent Ductus Arteriosus Management in Very Preterm Infants

Neonatology ◽  
2016 ◽  
Vol 109 (2) ◽  
pp. 139-146 ◽  
Author(s):  
Laura Bourgoin ◽  
Cecile Cipierre ◽  
Quentin Hauet ◽  
Helene Basset ◽  
Veronique Gournay ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Neurodevelopmental Outcome ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Patent Ductus
Sign in / Sign up

Export Citation Format

Share Document