Aims

Patent ductus arteriosus (PDA) is common in preterm infants and can contribute to morbidity and mortality. 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 <3000 g.

Methods and results

A total of 147 babies from three tertiary centres were retrospectively analysed. Sixty-four babies undergoing catheter closure were compared with 83 matched surgical cases. Patent ductus arteriosus closure was successful in all cases. During neonatal unit course, mortality was 6.3% (n = 4) after catheterization and 12% (n = 10) after surgery (p = 0.24). Median duration of mechanical 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 associated with shorter mechanical ventilation than after surgery. Hospital stay might be shorter when performed earlier in life.

中文翻译：

---

与导管闭合动脉导管未闭相比，经导管术后早产婴儿的通气得到改善。

目的

动脉导管未闭（PDA）在早产儿中很常见，可导致发病和死亡。我们的目的是比较2个匹配组<3000 g的早产儿，分别使用Amplatzer Piccolo咬合器和手术闭合进行经导管闭合的结果和结果。

方法与结果

回顾性分析了来自三个大专院校的147名婴儿。将64例接受导管闭合的婴儿与83例匹配的手术病例进行比较。在所有情况下，动脉导管未闭均成功。在新生儿病程中， 导管插入术后死亡率为6.3％（n = 4），手术后死亡率为12％（n  = 10）（p  = 0.24）。导管插入后机械通气的中位时间短于手术后（3天比5天，p  = 0.035）。在4周龄之前，经导管和手术关闭以进行机械通气之间的差异更加明显（3天与9天，p = 0.022）。此外，当前4周进行导尿，婴儿被家里同期相比那些为排出谁接受封闭以后的生活（39 ⁺¹与42 ⁺¹周，p  = 0.021）。在手术组中未发现这种差异。

结论

经导管闭合动脉导管未闭是安全，有效的，并且与术后相比，机械通气时间短。在生命的早期进行住院可能会缩短住院时间。