Improved ventilation in premature babies after transcatheter versus surgical closure of patent ductus arteriosus
Résumé
Aims: Patent ductus arteriosus (PDA) is common in preterminfants and can contribute tomorbidity andmortality. We aimed to compare results and outcome of transcatheter closure using the Amplatzer Piccolo Occluder versus surgical closure in 2 matched groups of preterm infants weighing b3000 g.
Methods and results: A total of 147 babies from three tertiary centres were retrospectively analysed. Sixty-four babies undergoing catheter closurewere comparedwith 83matched surgical cases. Patent ductus arteriosus closurewas successful in all cases. During neonatal unit course, mortalitywas 6.3% (n= 4) after catheterization and 12% (n= 10) after surgery (p= 0.24). Median duration ofmechanical ventilation was shorter after catheterisation than after surgery (3 vs 5 days, p= 0.035). Before 4 weeks of age the difference between transcatheter and surgical closure for mechanical ventilation was even more pronounced (3 vs 9 days, p = 0.022). Additionally, when catheterisation was performed before 4 weeks, babies were discharged home earlier as compared to those who underwent closure later in life (39(+1) vs. 42(+1) weeks, p = 0.021). Such difference was not found in the surgical group.
Conclusions: Transcatheter closure of patent ductus arteriosus is safe, effective and is associatedwith shorter mechanical ventilation than after surgery. Hospital stay might be shorter when performed earlier in life.