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Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams
Persistent patent ductus arteriosus (PDA) is very common in preterm infants, especially in extremely preterm infants. Despite significant advances in management of these vulnerable infants, there has been no consensus on management of PDA—when should we treat, who should we treat, how should we trea...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536298/ https://www.ncbi.nlm.nih.gov/pubmed/33072674 http://dx.doi.org/10.3389/fped.2020.558256 |
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author | Fraisse, Alain Bautista-Rodriguez, Carles Burmester, Margarita Lane, Mary Singh, Yogen |
author_facet | Fraisse, Alain Bautista-Rodriguez, Carles Burmester, Margarita Lane, Mary Singh, Yogen |
author_sort | Fraisse, Alain |
collection | PubMed |
description | Persistent patent ductus arteriosus (PDA) is very common in preterm infants, especially in extremely preterm infants. Despite significant advances in management of these vulnerable infants, there has been no consensus on management of PDA—when should we treat, who should we treat, how should we treat and in fact there is no agreement on how we should define a hemodynamically significant PDA. Medical management with non-steroidal anti-inflammatory drugs (NSAIDs) remains the first line of therapy with moderate success rate in closing the PDA. Paracetamol has been reported to be a safe and equally effective medical therapy for closure of PDA. However, additional studies on its long-term safety and efficacy in extremely low birth weight infants are needed before paracetamol can be recommended as standard treatment for a PDA in preterm infants. Surgical ligation of PDA is not without an increased risk of mortality and co-morbidities. Recently, there has been a significant interest in percutaneous transcatheter closure of PDA in preterm infants, including extremely low birth weight infants. Transcatheter PDA closure in preterm ELBW infants is technically feasible with high PDA occlusion success rates and acceptable complication rates as compared to surgical ligation. Many centers have reported promising early- and mid-term follow-up results. However, they need to be further tested in the prospective well-designed studies and randomized controlled trials comparing the results and outcomes of this technique with current treatment strategies including medical treatment before they can be used as the new standard of care for PDA closure in extremely low birth weight infants. |
format | Online Article Text |
id | pubmed-7536298 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75362982020-10-16 Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams Fraisse, Alain Bautista-Rodriguez, Carles Burmester, Margarita Lane, Mary Singh, Yogen Front Pediatr Pediatrics Persistent patent ductus arteriosus (PDA) is very common in preterm infants, especially in extremely preterm infants. Despite significant advances in management of these vulnerable infants, there has been no consensus on management of PDA—when should we treat, who should we treat, how should we treat and in fact there is no agreement on how we should define a hemodynamically significant PDA. Medical management with non-steroidal anti-inflammatory drugs (NSAIDs) remains the first line of therapy with moderate success rate in closing the PDA. Paracetamol has been reported to be a safe and equally effective medical therapy for closure of PDA. However, additional studies on its long-term safety and efficacy in extremely low birth weight infants are needed before paracetamol can be recommended as standard treatment for a PDA in preterm infants. Surgical ligation of PDA is not without an increased risk of mortality and co-morbidities. Recently, there has been a significant interest in percutaneous transcatheter closure of PDA in preterm infants, including extremely low birth weight infants. Transcatheter PDA closure in preterm ELBW infants is technically feasible with high PDA occlusion success rates and acceptable complication rates as compared to surgical ligation. Many centers have reported promising early- and mid-term follow-up results. However, they need to be further tested in the prospective well-designed studies and randomized controlled trials comparing the results and outcomes of this technique with current treatment strategies including medical treatment before they can be used as the new standard of care for PDA closure in extremely low birth weight infants. Frontiers Media S.A. 2020-09-22 /pmc/articles/PMC7536298/ /pubmed/33072674 http://dx.doi.org/10.3389/fped.2020.558256 Text en Copyright © 2020 Fraisse, Bautista-Rodriguez, Burmester, Lane and Singh. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Fraisse, Alain Bautista-Rodriguez, Carles Burmester, Margarita Lane, Mary Singh, Yogen Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams |
title | Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams |
title_full | Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams |
title_fullStr | Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams |
title_full_unstemmed | Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams |
title_short | Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams |
title_sort | transcatheter closure of patent ductus arteriosus in infants with weight under 1,500 grams |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536298/ https://www.ncbi.nlm.nih.gov/pubmed/33072674 http://dx.doi.org/10.3389/fped.2020.558256 |
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