Primary Surgical Closure Should Be Considered in Premature Neonates with Large Patent Ductus Arteriosus
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 178-184, 2013.
Article
Dans Anglais
| WPRIM
| ID: wpr-129687
ABSTRACT
BACKGROUND:
Treatment for patent ductus arteriosus (PDA) in premature infants can consist of medical or surgical approaches. The appropriate therapeutic regimen remains contentious. This study evaluated the role of surgery in improving the survival of premature neonates weighing less than 1,500 g with PDA. MATERIALS ANDMETHODS:
From January 2008 to June 2011, 68 patients weighing less than 1,500 g with PDA were enrolled. The patients were divided into three groups a group managed only by medical treatment (group I), a group requiring surgery after medical treatment (group II), and a group requiring primary surgical treatment (group III).RESULTS:
The rate of conversion to surgical methods due to failed medical treatment was 67.6% (25/37) in the patients with large PDA (> or =2 mm in diameter). The number of patients who could be managed with medical treatment was nine which was only 20.5% (9/44) of the patients with large PDA. There was no surgery-related mortality. Group III displayed a statistically significantly low rate of development of bronchopulmonary dysplasia (BPD) (p=0.008). The mechanical ventilation time was significantly longer in group II (p=0.002).CONCLUSION:
Medical treatment has a high failure rate in infants weighing less than 1,500 g with PDA exceeding 2.0 mm. Surgical closure following medical treatment requires a longer mechanical ventilation time and increases the incidence of BPD. Primary surgical closure of PDA exceeding 2.0 mm in the infants weighing less than 1,500 g should be considered to reduce mortality and long-term morbidity events including BPD.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Ventilation artificielle
/
Dysplasie bronchopulmonaire
/
Prématuré
/
Incidence
/
Persistance du canal artériel
Type d'étude:
Etude d'incidence
/
Étude pronostique
Limites du sujet:
Humains
/
Bébé
/
Nouveau-né
langue:
Anglais
Texte intégral:
The Korean Journal of Thoracic and Cardiovascular Surgery
Année:
2013
Type:
Article
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