scholarly journals Respiratory Trajectory after Invasive Interventions for Patent Ductus Arteriosus of Preterm Infants

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 398
Author(s):  
Yu-Jen Wei ◽  
Yen-Ju Chen ◽  
Yung-Chieh Lin ◽  
Chung-Dann Kan ◽  
Min-Ling Hsieh ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Post Intervention ◽  
Vlbw Infants ◽  
Transcatheter Occlusion ◽  
Surgical Ligation ◽  
Group A ◽  
Respiratory Outcomes ◽  
Patent Ductus ◽  
Invasive Intervention

Invasive interventions have been conducted in preterm infants with significant patent ductus arteriosus (PDA) when medical treatment has failed, and methods of invasive intervention have been reported. Surgical ligation via lateral thoracotomy has been a well-established procedure for decades. Recently, transcatheter occlusion has been safely and feasibly applied to the premature population. However, little research has been conducted on the benefits of transcatheter occlusion in very-low-birth-weight (VLBW) infants compared to surgical ligation. This study compared transcatheter and surgical techniques in VLBW infants in terms of short-term respiratory outcomes. The medical records of 401 VLBW infants admitted to a tertiary hospital between September 2014 and January 2019 were retrospectively reviewed. Patients who were diagnosed with a congenital anomaly, a chromosomal anomaly, or congenital heart disease, except for an inter-atrial shunt, were excluded. The perinatal conditions, neonatal morbidities, periprocedural vital signs, and respiratory support trajectories were compared between the transcatheter-treated and surgically ligated group. A total of 31 eligible VLBW infants received invasive intervention: 14 were treated with transcatheter occlusion (Group A), and 17 infants were treated with surgical ligation (Group B). Respiratory outcomes were not statistically significant between the two groups, despite Group A showing a trend toward early improvement in post-intervention respiratory trajectory. In this small case study, a different trend in post-intervention respiratory trajectories was observed. Future research with larger case numbers should be conducted to address our preliminary observations in more detail.

scholarly journals Patent ductus arteriosus treatment trends and associated morbidities in neonates

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joonsik Park ◽  
So J Yoon ◽  
Jungho Han ◽  
In G Song ◽  
Joohee Lim ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Careful Consideration ◽  
Vlbw Infants ◽  
Surgical Ligation ◽  
Oral Ibuprofen ◽  
Intravenous Ibuprofen ◽  
Patent Ductus

AbstractTo evaluate national epidemiologic data on infants treated for patent ductus arteriosus (PDA) in Korea and analyze outcomes associated with different PDA treatments. We retrospectively evaluated data on 12,336 patients diagnosed with PDA (International Classification of Diseases-10 code: Q250) between 2015 and 2018 from the Health Insurance Review and Assessment database. Among them, 1623 patients underwent surgical ligation (code: O1671). We used birth certificate data from Statistics Korea to estimate the prevalence, diagnosis, and treatment of PDA. The prevalence of infants with PDA was 81 infants per 10,000 live births and 45.2% in very low birth weight (VLBW) infants, which increased from 2015 to 2018. PDA ligation was performed in 2571 infants and 22% VLBW infants. Medical treatment was administered to 4202 infants, which decreased significantly, especially in VLBW infants (62% to 53%). The proportion of treatment was as follows: conservative treatment (53.1%), intravenous ibuprofen (24.4%), surgery (20.4%), and oral ibuprofen (10.7%); that among 4854 VLBW infants was as follows: intravenous ibuprofen (46.3%), conservative treatment (33.2%), surgery (22.2%), and oral ibuprofen (14.2%). Surgical treatment had a significantly higher risk (odds ratio 1.36) of mortality than conservative treatment. Surgical and/or medical treatments were associated with a higher risk of morbidity. Recently, increased use of conservative management of PDA has contributed to improved neonatal outcomes in VLBW infants. Select patients may still benefit from surgical ligation following careful consideration.

scholarly journals Patent Ductus Arteriosus Treatment Trends and Associated Morbidities in Neonates

2021 ◽  
Author(s):  
Joonsik Park ◽  
In Gyu Song ◽  
Joohee Lim ◽  
Jeong Eun Shin ◽  
Ho Seon Eun ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Careful Consideration ◽  
Vlbw Infants ◽  
Surgical Ligation ◽  
Oral Ibuprofen ◽  
Intravenous Ibuprofen ◽  
Patent Ductus

Abstract Objectives: To evaluate national epidemiologic data on infants treated for patent ductus arteriosus (PDA) in Korea and analyze outcomes associated with different PDA treatments. Study Design: We retrospectively evaluated data on 12,336 patients diagnosed with PDA (International Classification of Diseases-10 code: Q250) between 2015 and 2018 from the Health Insurance Review and Assessment database. Among them, 1,623 patients underwent surgical ligation (code: O1671). We used birth certificate data from Statistics Korea to estimate the prevalence, diagnosis, and treatment of PDA. Results: The prevalence of infants with PDA was 81 infants per 10,000 live births and 45.2% in very low birth weight (VLBW) infants, which increased from 2015 to 2018. PDA ligation was performed in 2571 infants and 22% VLBW infants. Medical treatment was administered to 4202 infants, which decreased significantly, especially in VLBW infants (62% to 53%). The proportion of treatment was as follows: conservative treatment (53.1%), intravenous ibuprofen (24.4%), surgery (20.4%), and oral ibuprofen (10.7%); that among 4,854 VLBW infants was as follows: intravenous ibuprofen (46.3%), conservative treatment (33.2%), surgery (22.2%), and oral ibuprofen (14.2%). Surgical treatment had a significantly higher risk (odds ratio 1.36) of mortality than conservative treatment. Surgical and/or medical treatments were associated with a higher risk of morbidity.Conclusion: Recently, increased use of conservative management of PDA has contributed to improved neonatal outcomes in VLBW infants. Select patients may still benefit from surgical ligation following careful consideration.

Clinical Analysis of Thrombocytopenia following Transcatheter Occlusion of a Patent Ductus Arteriosus

Cardiology ◽  
2020 ◽  
pp. 1-5
Author(s):  
Ang Li ◽  
Dan Yin ◽  
Xupei Huang ◽  
Lixin Zhang ◽  
Tiewei Lv ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Clinical Analysis ◽  
Good Prognosis ◽  
Severe Thrombocytopenia ◽  
Residual Shunt ◽  
Transcatheter Occlusion ◽  
High Risk Factors ◽  
Median Diameter ◽  
Patent Ductus

<b><i>Background:</i></b> Our aim is to analyze the correlation between severe thrombocytopenia and the diameter of patent ductus arteriosus (PDA) and residual shunt after PDA closure. <b><i>Methods:</i></b> The patients with severe thrombocytopenia (platelet count &#x3c;50 × 10<sup>9</sup>/L) following transcatheter occlusion of a PDA from January 2010 to December 2018 in the Children’s Hospital of Chongqing Medical University were collected. And the high-risk factors, diagnosis, treatment, and prognosis of severe thrombocytopenia were analyzed. <b><i>Results:</i></b> A total of 1,581 children with transcatheter occlusion of a PDA were collected; 22 (1.39%) of the enrolled patients had severe thrombocytopenia. Further data analysis showed that the median diameter of PDA (6.7 [IQR: 1.63]) mm in children with severe thrombocytopenia was significantly larger than that in children without severe thrombocytopenia (3.6 ± 1.7 mm, <i>p</i> &#x3c; 0.001). Furthermore, the incidence of thrombocytopenia in children with residual shunt after operation (10.9%) was significantly higher than that in children without residual shunt (0.2%, <i>p</i> &#x3c; 0.001). The mean time of thrombocytopenia was found to be 2.4 ± 1.3 days after intervention. All patients with thrombocytopenia were treated by methylprednisolone with or without platelet transfusion and recovered without major organ hemorrhage. <b><i>Conclusions:</i></b> Severe thrombocytopenia following transcatheter occlusion of a PDA may be related to the larger diameter of PDA and residual shunt. If early detection of severe thrombocytopenia is obtained, our study supports a good prognosis if appropriate measures are implemented.

The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks

2021 ◽  
Vol 56 (4) ◽  
pp. 300-307
Author(s):  
Adil Umut Zubarioglu ◽  
◽  
Ozgur Yildirim ◽  
Cenap Zeybek ◽  
Ismail Balaban ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Surgical Ligation ◽  
Premature Babies ◽  
Patent Ductus ◽  
The Ideal

Transcatheter occlusion of patent ductus arteriosus using coil embolization

1997 ◽  
Vol 60 (2) ◽  
pp. 133-138 ◽  
Author(s):  
José Luiz B Jacob ◽  
Wilson M.C Coelho ◽  
Nilton C.S Machado ◽  
Sérgio A.C Garzon
Keyword(s):  
Patent Ductus Arteriosus ◽  
Coil Embolization ◽  
Ductus Arteriosus ◽  
Transcatheter Occlusion ◽  
Patent Ductus

Transcatheter occlusion of the patent ductus arteriosus: a comparison of two devices

2002 ◽  
Vol 171 (3) ◽  
pp. 151-154
Author(s):  
M. K. El Mallah ◽  
A. J. Sands ◽  
F. A. Casey ◽  
B. G. Craig ◽  
H. C. Mulholland
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Transcatheter Occlusion ◽  
Patent Ductus

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.

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