PATENT DUCTUS ARTERIOSUS DEVICE CLOSURE VERSUS SURGICAL LIGATION IN INFANTS | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 1, Volume 24, Issue 2, April 2021, Page 1945-1963 PDF (257.88 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2021.194410 | ||||
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| Abstract | ||||
| Background: Patent ductus arteriosus (PDA) is a congenital heart abnormality constituting nearly 10% of all congenital heart disease, and it is the third most common congenital heart defect. Transcatheter closure of patent ductus arteriosus now represents the established, standard approach for the correction of a PDA throughout the entire world. This study was a prospective observational study. The aim of this study was to compare the feasibility, short-term clinical outcomes, and safety of transcatheter closure of moderate to large patent ductus arteriosus in small infants versus surgical ligation and to follow the sequences after both methods of ductal closure by transthoracic echocardiography. Methods: All patients were subjected to full clinical examination, chest X-ray, electrocardiography, echocardiography, and laboratory evaluation before they were transferred to the catheterization laboratory for undergoing an attempt of PDA closure or surgical duct ligation. Within 24 hours after successful PDA closure, all patient underwent echocardiographic examination to evaluate for presence of residual shunt and protrusion of devices into surrounding structures. Follow up visits have been scheduled at 1 and 6 months after the procedures for clinical and echocardiographic evaluation. Results: This study was conducted on 40 patients, 20 cases in catheter group and 20 cases in surgery group: 12 (30%) were males and 28 (70%) were females. The mean age was 6.5 ± 1.9 months in catheter group and 4.7 ± 1.8 months in Surgery group, while mean weight was 5.6 ± 0.5 Kg and 4.6 ± 0.8 Kg in Catheter and Surgery groups respectively. All patients had successful transcatheter and surgical PDA closure with no mortality in both study groups. PDA closure was done using ADO- I in 45% of cases (n=9/20). The sizes of the device were; ADO- I size 8/6 in 35% (n=7/20) represented the majority of patients, followed by ADO- I size 6/4 in 10% (n=2/20). Double PDA ligation and trans-fixation was the most common technique used in surgery group (95%). Our intervention was without Procedure-related complications in 80% of cases of catheter group and 85% of surgery cases. Time to discharge from hospital was shorter in catheter group with median time to hospital discharge 1 day versus 4 days in surgery group. Both methods of PDA closure showed similar results as regard residual shunts and regression of left side dilatation. | ||||
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