Document Detail


Surgical ligation of patent ductus arteriosus in premature infants.
MedLine Citation:
PMID:  20515605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The objective was to evaluate the mortality and the morbidity in neonates operated for persistent ductus arteriosus at Copenhagen University Hospital in the 10-year period from 1 January 1998 to 31 December 2007, and to compare the results with results reported in extant literature. MATERIAL AND METHODS: Patient data were collected by retrospective audit of medical charts. Infants with complex heart disease were excluded. The outcomes were mortality, necrotising enterocolitis (NEC), intraventricular haemorrhage (IVH), paresis of the recurrent laryngeal nerve and chylothorax. For statistical analyses, we used Fisher's exact test and Mann-Whitney U test. RESULTS: We included 46 neonates among an initial 60 candidates. Gestational age was from 23 + 6 to 34 + 0 weeks (mean 26 + 6.5) and the birth weight ranged from 535 g to 1,793 g (mean 943.5 g). In 93% of the cases, the left atrium diameter (LAD)/aorta diameter (Ao)-ratio measured by echocardiography was greater than or equal to 1.5, and medical closure had been attempted in 93% of the cases. After surgical ligation, there were three cases of paresis of the recurrent laryngeal nerve, two cases of chylothorax, eight cases of NEC, four cases of IVH and seven deaths (15.2%). The deaths occurred between three and 119 days postoperatively. Those who died were operated at an earlier age than the remaining patients (p < 0.05) and they tended to be of lower gestational age and to have a lower birth weight (p > 0.05) than those who survived. CONCLUSION: The need for ligation of a patent arterial duct in preterm neonates is subject to considerable risk. Total mortality in this vulnerable group of patients was 15%. Although no obviously procedure-related deaths were observed, severe complications and postoperative morbidity occurred.
Authors:
Cristel M Sørensen; Jesper N Steensberg; Gorm Greisen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Danish medical bulletin     Volume:  57     ISSN:  1603-9629     ISO Abbreviation:  Dan Med Bull     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0066040     Medline TA:  Dan Med Bull     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  A4160     Citation Subset:  IM    
Affiliation:
University of Copenhagen. cristel.soerensen@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / adverse effects,  mortality*
Chylothorax / etiology
Denmark / epidemiology
Ductus Arteriosus, Patent / surgery*
Enterocolitis, Necrotizing / etiology
Hospitals, University / statistics & numerical data
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / surgery*
Ligation / adverse effects,  mortality
Medical Audit*
Recurrent Laryngeal Nerve / injuries
Comments/Corrections
Republished in:
Ugeskr Laeger. 2010 Jun 21;172(25):1909   [PMID:  20586130 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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