Document Detail


Surgical ligation of patent ductus arteriosus in very low birth weight infants: is it safe?
MedLine Citation:
PMID:  9764713     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated the outcome of a combined medical and surgical treatment of patent ductus arteriosus (PDA) in newborns weighing less than 1500 g. Charts were retrospectively reviewed for 76 newborns with a PDA between 1993 and 1997. Thirteen infants had pre-existing conditions prohibiting the use of indomethacin; eight were managed surgically, five medically. The remaining 63 infants received indomethacin therapy. Thirty-two medical failures occurred, requiring surgical ligation of the PDA. Those requiring surgery had a lower average birth weight (847 versus 997 g) and gestational age (26 versus 28 weeks; P < 0.05). Indomethacin treatment was successful in 27 infants. There were only three operative complications: a small pneumothorax, wound bleeding, and a small aortic tear. All recovered uneventfully and no deaths were attributable to the surgical procedure itself. There was no difference in the incidence of respiratory distress syndrome, duration of intubation, sepsis, neonatal enterocolitis, renal dysfunction, bleeding disorders, or intraventricular hemorrhage among both groups. Surgical ligation of a PDA is associated with a high success rate, a low incidence of complications, and no additional morbidity than indomethacin alone. We propose that surgical ligation should be regarded as a first line therapy for very small premature infants who are at higher risk of medical failure.
Authors:
C A Perez; J M Bustorff-Silva; E Villasenor; E W Fonkalsrud; J B Atkinson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  64     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1998-10-16     Completed Date:  1998-10-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1007-9     Citation Subset:  IM    
Affiliation:
Division of Pediatric Surgery, University of California at Los Angeles School of Medicine, 90095-1749, USA.
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MeSH Terms
Descriptor/Qualifier:
Ductus Arteriosus, Patent / mortality,  surgery*
Female
Humans
Indomethacin / administration & dosage
Infant, Newborn
Infant, Premature, Diseases / mortality,  surgery*
Infant, Very Low Birth Weight*
Ligation
Male
Postoperative Complications / etiology,  mortality
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
53-86-1/Indomethacin

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


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