Day-case ligation of patent ductus arteriosus in premature infants

Malone, P.S.; Roberts, Keith; Abrams, L. D.; Jones, Susan; Beasley, J.M.

doi:10.1016/s0022-3468(87)80349-4

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…The results from this three centre study show high survival rates of 98% and 92% at 7 and 30 days respectively following surgical PDA ligation. These rates are similar to previous studies that have shown that PDA ligation is a relatively safe procedure [ 7 , 8 ], whether it is done on a NICU [ 9 ] or after transfer to a cardio-thoracic centre [ 10 ]. In the NICU (centre A) the procedure was performed by one of two consultant adult cardio-thoracic surgeons trained in PDA ligation.…”

Section: Discussionsupporting

confidence: 89%

Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

et al. 2006

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BackgroundThe patent ductus arteriosus (PDA) is an important problem in premature infants. Surgical PDA ligation is usually only be considered when medical treatment has either failed or was contraindicated. The aims of our study were to determine the mortality and morbidity following patent ductus arteriosus ligation in premature infants, and whether prostaglandin synthetase inhibitor (PSI) use prior to ligation affects outcome.MethodsA retrospective case note review study to determine the outcome of premature infants undergoing patent ductus arteriosus ligation in one tertiary neonatal intensive care unit and two paediatric cardiothoracic centres.ResultsWe had follow-up data on 87 infants. Cumulative mortality rates at 7 days, 30 days and at hospital discharge were 2%, 8% and 20% respectively. The incidence of chronic lung disease, intraventricular haemorrhage, necrotising enterocolitis and retinopathy of prematurity were 77%, 39%, 26% and 28% respectively. There was no difference in mortality, incidence of chronic lung disease or duration of oxygen dependence between those who had and those who had not received a PSI prior to surgical ligation. In those who had received 2 or more courses of PSI prior to surgical ligation, there was a trend to increase in the duration of oxygen therapy and chronic lung disease, but no difference in mortality.ConclusionThis study shows that patent ductus arteriosus ligation is a relatively safe procedure (30 day survival 92%) but there is substantial late mortality and a high incidence of morbidity in the survivors. 2 or more courses of PSI prior to surgical ligation trends to increased oxygen dependence and chronic lung disease. This high risk population requires careful follow-up. A definitive prospective cohort study is lacking.

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Section: Discussionsupporting

confidence: 89%

Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

et al. 2006

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“…The mean waiting time of 7 days might be reduced if more procedures were performed as day cases. 27 However, these extremely small ventilated infants often do not tolerate long transfers well. The referral process could be improved by providing adequate capacity in the surgical centres for this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…Arranging patent ductus arteriosus ligation can be difficult with significant delays following referral due to lack of capacity in the surgical units. The mean waiting time of 7 days might be reduced if more procedures were performed as day cases 27 . However, these extremely small ventilated infants often do not tolerate long transfers well.…”

Section: Discussionmentioning

confidence: 99%

Outcome of patent ductus arteriosus ligation in premature infants in the East of England: a prospective cohort study

et al. 2012

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Patent ductus arteriosus ligation in premature infants is associated with low mortality and complication rates; however, there is a high incidence of neonatal morbidity. Surgical capacity for patent ductus arteriosus ligation needs to be carefully planned nationally as the duration of ‘‘waiting time’’ and transport to another surgical centre could adversely affect outcomes in this high-risk population.

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“…There has been a single report of neonates undergoing duct ligation as a day case. 7 It has been our practice to have each baby transported from the referring neonatal unit to this supraregional cardiothoracic centre for duct ligation. The infants were then transported back to their units immediately after the procedure.…”

Section: Introductionmentioning

confidence: 99%

Day case ligation of patent ductus arteriosus in preterm infants: a 10 year review.

Satur

Walker

Dickinson

1991

Archives of Disease in Childhood

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Since 1978, 136 preterm babies received ligation of a patent ductus arteriosus as day cases. A total of 122 babies whose notes were available for review, with a median gestational age of 27 weeks (range 23-35) and median birth weight of 960 g (range 470-2750), were transported distances of up to 80 miles. The median ages at ligation with and without previous medical management with indomethacin were 23 and 15 days, respectively. One hundred and ten (90%) babies were dependent on ventilatory support, but extubation was achieved at a median time of 10 days after ligation, regardless of postnatal age at the time of ligation. There were no deaths associated with the operation, and no complications resulting from transportation. The hospital mortality was 15 (12.3%), and the most important (and significant) adverse factor was a preoperative fractional inspiratory oxygen content greater than 0 3. The results of this study show that day case ligation of the patent ductus arteriosus is safe, and if it is carried out early will reduce the time before extubation and discharge from the intensive care unit.

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Day-case ligation of patent ductus arteriosus in premature infants

Cited by 5 publications

References 6 publications

Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis

Outcome of patent ductus arteriosus ligation in premature infants in the East of England: a prospective cohort study

Day case ligation of patent ductus arteriosus in preterm infants: a 10 year review.

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