Optimal timing of video-assisted thoracoscopic surgery for patent ductus arteriosus in preterm infants born at ≤ 28 weeks of gestation.
Age Factors
Cardiovascular Agents
/ therapeutic use
Ductus Arteriosus, Patent
/ drug therapy
Female
Humans
Indomethacin
/ therapeutic use
Infant, Extremely Premature
Infant, Newborn
Infant, Premature, Diseases
/ drug therapy
Male
Prognosis
Retrospective Studies
Thoracic Surgery, Video-Assisted
/ methods
Treatment Outcome
bronchopulmonary dysplasia
extremely low-birthweight
patent ductus arteriosus
premature
video-assisted thoracoscopic surgery for patent ductus arteriosus
Journal
Pediatrics international : official journal of the Japan Pediatric Society
ISSN: 1442-200X
Titre abrégé: Pediatr Int
Pays: Australia
ID NLM: 100886002
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
24
06
2018
revised:
09
01
2019
accepted:
01
03
2019
pubmed:
15
6
2019
medline:
13
2
2020
entrez:
15
6
2019
Statut:
ppublish
Résumé
Video-assisted thoracoscopic surgery for patent ductus arteriosus (VATS-PDA) is an alternative surgical procedure to open chest surgery, even in premature infants. This study investigated whether the timing of VATS-PDA has a prognostic impact in premature infants whose operative indication was determined according to the symptomatic PDA and the ineffectiveness of or contraindication to indomethacine therapy. We studied 49 infants born at or before 28 weeks of gestation who were admitted to the neonatal intensive care unit between January 2004 and June 2016, and who underwent VATS-PDA. The patients were divided into two groups according to median age at the time of surgery (early group, 24 infants who underwent surgery at ≤ 24 days of life; late group, 25 infants who underwent surgery at ≥ 25 days of life). No significant differences were found in bodyweight at 30 days of age and 40 weeks of corrected gestational age between the groups. The timing of surgery did not affect the operative procedure or postoperative complications. In addition, no differences were observed between the early and late groups in terms of complications associated with prematurity, including intraventricular hemorrhage, incidence and severity of bronchopulmonary dysplasia, and necrotizing enteropathy. Video-assisted thoracoscopic surgery for patent ductus arteriosus can be safely performed in premature infants without a preferential timing for the intervention, suggesting that this procedure allows for an elective basis approach after heart failure management with conservative and/or drug therapy in premature infants with PDA.
Sections du résumé
BACKGROUND
BACKGROUND
Video-assisted thoracoscopic surgery for patent ductus arteriosus (VATS-PDA) is an alternative surgical procedure to open chest surgery, even in premature infants. This study investigated whether the timing of VATS-PDA has a prognostic impact in premature infants whose operative indication was determined according to the symptomatic PDA and the ineffectiveness of or contraindication to indomethacine therapy.
METHODS
METHODS
We studied 49 infants born at or before 28 weeks of gestation who were admitted to the neonatal intensive care unit between January 2004 and June 2016, and who underwent VATS-PDA. The patients were divided into two groups according to median age at the time of surgery (early group, 24 infants who underwent surgery at ≤ 24 days of life; late group, 25 infants who underwent surgery at ≥ 25 days of life).
RESULTS
RESULTS
No significant differences were found in bodyweight at 30 days of age and 40 weeks of corrected gestational age between the groups. The timing of surgery did not affect the operative procedure or postoperative complications. In addition, no differences were observed between the early and late groups in terms of complications associated with prematurity, including intraventricular hemorrhage, incidence and severity of bronchopulmonary dysplasia, and necrotizing enteropathy.
CONCLUSION
CONCLUSIONS
Video-assisted thoracoscopic surgery for patent ductus arteriosus can be safely performed in premature infants without a preferential timing for the intervention, suggesting that this procedure allows for an elective basis approach after heart failure management with conservative and/or drug therapy in premature infants with PDA.
Substances chimiques
Cardiovascular Agents
0
Indomethacin
XXE1CET956
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
792-796Informations de copyright
© 2019 Japan Pediatric Society.
Références
Knight DB. The treatment of patent ductus arteriosus in preterm infants. A review and overview of randomized trials. Semin. Neonatol. 2001; 6: 63-73.
Noori S, McCoy M, Friedlich P, et al. Failure of ductus arteriosus closure is associated with increased mortality in preterm infants. Pediatrics 2009; 123: 138-44.
Landreneau RJ, Hazelrigg SR, Mack MJ, et al. Postoperative pain-related morbidity: Video-assisted thoracoscopic surgery versus thoracotomy. Ann. Thorac. Surg. 1993; 56: 1285-9.
Burke RP, Jacobs JP, Cheng W, et al. Video-assisted thoracoscopic surgery for patent ductus arteriosus in low birth weight neonates and infants. Pediatrics 1999; 104: 227-30.
Jaillard S, Larrue B, Rakza T, et al. Consequence of delayed surgical closure of patent ductus arteriosus in very premature infants. Ann. Thorac. Surg. 2006; 81: 231-4.
Villa E, Eynden FV, Bret EL, et al. Pediatric video-assisted thoracoscopic clipping of patent ductus arteriosus: Experience in more than 700 cases. Eur. J. Cardiothorac. Surg. 2004; 25: 387-93.
Hines MH, Raise KH, Payne M, et al. Video-assisted ductal ligation in premature infants. Ann. Thorac. Surg. 2003; 76: 1417-20.
Vanamo K, Berg E, Kokki H, et al. Video-assisted thoracoscopic versus open surgery for persistent ductus arteriosus. J. Pediatr. Surg. 2006; 41: 1226-9.
Kemmochi M, Miyaji K, Yamaguchi A, et al. Outcomes of neonates of less than 25 weeks of gestational age using video-assisted thoracoscopic surgery for patent ductus arteriosus. J. Jpn. Soc. Perinat. Neonatal Med. 2015; 51: 1161-6. (in Japanese).
Ibrahim MH, Azab AA, Kamal NM, et al. Outcomes of early ligation of patent ductus arteriosus in preterms, multicenter experience. Medicine (Baltimore) 2015; 94: e915.
Hsiao CC, Wung JT, Tsao LY, Chang WC. Early or late ligation of medical refractory patent ductus arteriosus in premature infants. J. Formos. Med. Assoc. 2009; 108: 72-7.
Sung SI, Choi SY, Park JH, et al. The timing of surgical ligation for patent ductus arteriosus is associated with neonatal morbidity in extremely preterm infants born at 23-25 weeks of gestation. J. Korean Med. Sci. 2014; 29: 581-6.
Wickremasinghe AC, Rogers EE, Piecuch RE, et al. Neurodevelopmental outcomes following two different treatment approaches (early ligation and selective ligation) for patent ductus arteriosus. J. Pediatr. 2012; 161: 1065-72.
Mosalli R, Alfaleh K, Paes B. Role of prophylactic surgical ligation of patent ductus arteriosus in extremely low birth weight infants: Systematic review and implications for clinical practice. Ann. Pediatr. Cardiol. 2009; 2: 120-6.
Madan JC, Kendrick D, Hagadorn JI, et al. Patent ductus arteriosus therapy : Impact on neonatal and 18 month outcome. Pediatrics 2009; 123: 674-81.
Clyman R, Cassady G, Kirklin JK, et al. The role of patent ductus arteriosus ligation in bronchopulmonary dysplasia: Reexamining a randomized controlled trial. J. Pediatr. 2009; 154: 873-6.
Jhaveri N, Moon-Grady A, Clyman RI. Early surgical ligation versus a conservative approach for management of patent ductus arteriosus that fails to close after indomethacin treatment. J. Pediatr. 2010; 157: 381-7.
Kabra NS, Schmidt B, Roberts RS, et al. Neurosensory impairment after surgical closure of patent ductus arteriosus in extremely low birth weight infants: Results from the trial of indomethacin prophylaxis in preterms. J. Pediatr. 2007; 250: 229-34.
Benitz WE. Committee on Fetus and Newborn, American Academy of Pediatrics. Patent ductus arteriosus in preterm infants. Pediatrics 2016; 137: 1-6.
El-Khuffash AF, Jain A, McNamara PJ. Ligation of the patent ductus arteriosus in preterm infants: Understanding the physiology. J. Pediatr. 2013; 162: 1100.