Extremely premature infants with patent ductus arteriosus closure Comparative analysis of surgical ligation versus cardiac catheterization-based closure

Our objective was to compare postprocedure hemodynamic decompensation in extremely premature infants who had their patent ductus arteriosus (PDA) closed with surgical ligation (SL) versus cardiac catheter-based closure (CCC). This is a single-center retrospective review of extremely premature ( < 28 weeks) infants who had their PDA closed by SL or CCC. Of the total of 69 infants, 53 underwent SL, and 16 had CCC. Infants in 2 groups were comparable at birth. However, at the time of the procedure, infants in the SL group were smaller, less mature, and had higher respiratory support. Vasopressor use, both pre- and postprocedure, was more common in the SL group. Nineteen percent of the infants in the SL group, compared to 6% in the CCC group (P = .34), required dose escalation or use of vasopressors after the PDA closure. There was no significant difference between the 2 groups in postoperative hemodynamic decompensation. Large, multicenter, prospective study or randomized control trial will help to confirm our findings.

Automated summary

This study compared the hemodynamic stability after closing patent ductus arteriosus (PDA) in extremely premature infants using surgical ligation (SL) or cardiac catheter-based closure (CCC). The SL group had smaller and less mature infants with higher respiratory support. However, there was no significant difference in postoperative hemodynamic decompensation between the two groups.