Timing of surgical ligation of patent ductus arteriosus in very low birth weight infants.
10.7499/j.issn.1008-8830.2112151
- Author:
Tai-Xiang LIU
1
;
Xiao-Lu MA
1
;
Zheng CHEN
1
;
Li-Ping SHI
1
Author Information
1. Department of Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine/National Clinical Research Center for Child Health, Hangzhou 310052, China.
- Publication Type:Journal Article
- Keywords:
Early surgical ligation;
Patent ductus arteriosus;
Preterm infant;
Very low birth weight infant
- MeSH:
Ductus Arteriosus, Patent/surgery*;
Gestational Age;
Humans;
Infant;
Infant, Newborn;
Infant, Very Low Birth Weight;
Ligation;
Retrospective Studies
- From:
Chinese Journal of Contemporary Pediatrics
2022;24(5):500-506
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To study the effect of timing of surgical ligation of patent ductus arteriosus (PDA) on the prognosis of very low birth weight infants (VLBWI).
METHODS:The medical data of VLBWI who underwent transthoracic ligation for PDA from June 2018 to May 2021 were reviewed retrospectively. The infants were divided into early ligation group (≤21 days of age) and late ligation group (>21 days of age) based on the age of ligation. The two groups were compared in terms of perioperative clinical features, complications, and mortality. The risk factors for early surgical ligation were analyzed.
RESULTS:A total of 72 VLBWI were enrolled, with 19 infants (26%) in the early ligation group and 53 infants (74%) in the late ligation group. There were significant differences in birth weight, gestational age, weight at operation, days of age at operation, rates of preoperative invasive and noninvasive mechanical ventilation, incidence rate of pulmonary hemorrhage, incidence rate of hypotension, preoperative PDA internal diameter (mm/kg), intraoperative PDA external diameter (mm/kg), incidence rate of post-ligation cardiac syndrome, and duration of postoperative invasive mechanical ventilation between the two groups (P<0.05). A binary logistic regression analysis showed that pulmonary hemorrhage was an indication of early surgical ligation of PDA (P<0.05). There were no significant differences in the incidence rates of post-operative complications and the mortality rate between the early ligation and late ligation groups.
CONCLUSIONS:Early surgical ligation may be performed for VLBWI who are experiencing pulmonary hemorrhage and hemodynamically significant PDA confirmed by cardiac ultrasound after birth. However, post-ligation cardiac syndrome should attract enough attention. In addition, early surgical ligation of PDA does not increase the risk of surgery-related and long-term complications or death, indicating that it is a safe and feasible treatment option.
