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Outcome of patent ductus arteriosus ligation in premature infants in the East of England: a prospective cohort study.
MedLine Citation:
PMID:  23164413     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Surgical ligation of patent ductus arteriosus is considered when medical treatment fails or is contraindicated. This study aims to determine the mortality and morbidity of preterm neonates referred for patent ductus arteriosus ligation. METHODS: A prospective study was conducted in the East of England to follow the outcome of premature infants under 37 weeks' gestation undergoing patent ductus arteriosus ligation. A standardised proforma was used to collect information before and after the procedure. RESULTS: A total of 102 premature infants were recruited, and patent ductus arteriosus ligation was performed in 92. Surgical complications occurred in 8.7% (8/92), which included pneumothorax (5/8), recurrent laryngeal nerve palsy (2/8), and chylothorax (1/8). Morbidity outcome data were not available for all infants. The incidence of chronic lung disease was 88% (88/99); intraventricular haemorrhage was 49% (49/100); necrotising enterocolitis 39% (39/99), and retinopathy of prematurity 42% (41/97). The overall mortality rate in our study was 7.8% (8/102). Mortality rate in infants who had patent ductus arteriosus ligation was 4.3% (4/92). The 30-day survival rate after ligation was 99% (91/92). Beyond 30 days post-ligation, three infants died from other causes that were not directly related to surgery. CONCLUSION: 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.
Authors:
Sok-Leng Kang; Salehuddin Samsudin; Minju Kuruvilla; Anshoo Dhelaria; Sue Kent; Wilfred A Kelsall
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-20
Journal Detail:
Title:  Cardiology in the young     Volume:  -     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-6     Citation Subset:  -    
Affiliation:
1 Paediatric Cardiology, University Hospital of Wales, Cardiff, United Kingdom.
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