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Outcome of ligation of the persistently patent arterial duct in neonates as performed by an outreach surgical team

Published online by Cambridge University Press:  01 October 2007

Shanmugasundaram Sivakumar ,
Lleona Lee ,
Angela Tillett ,
Francis Wells ,
Jon Dunning  and
A Wilf Kelsall
Shanmugasundaram Sivakumar
Affiliation:
Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
Lleona Lee
Affiliation:
Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
Angela Tillett
Affiliation:
Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
Francis Wells
Affiliation:
Cardiothoracic Surgical Unit, Papworth Hospital NHS Trust, Papworth Everard, Cambridge, United Kingdom
Jon Dunning
Affiliation:
Cardiothoracic Surgical Unit, Papworth Hospital NHS Trust, Papworth Everard, Cambridge, United Kingdom
A Wilf Kelsall*
Affiliation:
Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
*
Correspondence to: Dr A. Wilf Kelsall, NICU Box 226, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ, UK. Tel: +1223 216240; Fax: +1223 217064; E-mail: wilf.kelsall@addenbrookes.nhs.uk
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Abstract

Aim

Our aim was to review the outcome of ligation of the persistently patent arterial duct in neonates as performed outside a paediatric cardiothoracic centre by an outreach surgical team.

Methods

A retrospective observational study of all ligations of the persistently patent arterial duct performed in Cambridge between January, 1988, and December, 2002.

Results

Over the period of 15 years studied, a persistently patent arterial duct was ligated in 43 neonates. The median gestational age at birth was 26 weeks, with a range from 23 to 35 weeks, and median weight at birth was 722 grams, with a range from 500 to 2100 grams. Median age at ligation, was 25 days, with a range from 10 to 89 days, and their weight was 963 grams, with a range from 568 to 2221 grams. Ligation was successful in 42 babies (98%), mortality at 30 days of 5%, and 29 of the babies (67%) surviving to be discharged from the hospital. The late deaths were due to complications of prematurity, rather than the procedure of ligation.

Conclusion

The persistently patent arterial duct can successfully be ligated by an outreach surgical team outside a paediatric cardiothoracic centre. There was an excellent 30 day survival.

Keywords

Prematurityneonatal intensive care unitcardiothoracic centre
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 5 , October 2007 , pp. 541 - 544
Copyright
Copyright © Cambridge University Press 2007

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References

1.Knight, DB. The treatment of patent ductus arteriosus in preterm infants. A review and overview of randomised controlled trials. Semin Neonatol 2001; 6: 63–73.Google ScholarPubMed
2.Yeo, CL, Choo, S, Ho, LY. Chronic lung disease in very low birthweight infants: a 5-year review. J Paediatr Child Health 1997; 33: 102–106.CrossRefGoogle ScholarPubMed
3.Garland, J, Buck, R, Weinburg, M. Pulmonary hemorrhage risk with clinically diagnosed patent ductus arteriosus: a retrospective cohort study. Paediatrics 1994; 94: 719–723.CrossRefGoogle ScholarPubMed
4.Dyke, FD, Lazzara, A, Ahmann, P, Blumenstein, B, Schwartz, J, Brann, AW. Intraventricular haemorrhage: a prospective evaluation of etiopathogenesis. Paediatrics 1980; 66: 42–49.CrossRefGoogle Scholar
5.Coombs, RC, Morgan, MEI, Durbin, GM, Booth, IW, McNeish, AS. Gut blood flow velocities in the newborn: effects of patent ductus arteriosus and parental indomethacin. Arch Dis Child 1990; 65: 1067–1071.CrossRefGoogle Scholar
6.Wheatley, CM, Dickinson, JL, Mackey, DA, Craig, JE, Sale, MM. Retinopathy of prematurity: recent advances in our understanding. Br J Opthalmol 2002; 86: 696–700.CrossRefGoogle ScholarPubMed
7.Brooks, JM, Travadi, TN, Patole, SK, Doherty, DA, Simmer, K. Is surgical ligation of patent ductus arteriosus necessary? – The Western Australian experience of conservative management. Arch Dis Child Fetal Neonatal Ed 2005; 90: 235–239.CrossRefGoogle ScholarPubMed
8.Hwang, HK, Chen, MR, Wu, SJ, et al. . Surgical ligation of patent ductus arteriosus in extremely low birth weight premature neonates. Acta Cardiol Sin 2005; 21: 30–34.Google Scholar
9.Little, DC, Pratt, TC, Blalock, SE, Krauss, DR, Cooney, DR, Custer, MD. Patent ductus arteriosus in micropremies and full-term infants: relative merits of surgical ligation versus indomethacin treatment. J Pediatr Surg Mar 2003; 38: 492–496.CrossRefGoogle Scholar
10.Satur, CRM, Walker, DR, Dickinson, DF. Day Case ligation of patent ductus arteriosus in preterm infants: a 10 year review. Arch Dis Child 1991; 66: 477–480.CrossRefGoogle Scholar
11.Gould, DS, Montenegro, LM, Gaynor, JW, et al. . A comparison of on-site and off-site patent ductus arteriosus ligation in premature infants. Pediatrics 2003; 112: 1298–1301.CrossRefGoogle ScholarPubMed
12.Mortier, E, Ongenae, M, Vermassen, F, et al. . Operative closure of patent ductus arteriosus in the neonatal intensive care unit. Acta Chir Belg 1996; 96: 266–268.Google ScholarPubMed
13.Shenassa, H, Sankaran, K, Duncan, W, Tyrrell, M, Bharadwaj, B. Surgical ligation of patent ductus arteriosus in a neonatal intensive care setting is safe and cost effective. Can J Cardiol 1986; 2: 353–355.Google Scholar
14. The Bristol Royal Infirmary Inquiry. Learning from Bristol: Report of the Public Inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984–1995. Bristol Royal Infirmary Inquiry, July 2001. (CM 5207.) www.bristol-inquiry.org.uk.Google Scholar
15. Department of Health. Report of the Paediatric and Congenital Cardiac Services Review Group. London: DH, 2003. www.advisorybodies.doh.gov.uk/childcardiac/pccsreptdec03.pdf.Google Scholar