Determinants of surgical repair of patent ductus arteriosus in low-birth-weight infants

• Published in: Journal of medical ultrasonics (2001) Vol. 38; no. 3; pp. 151 - 155
• Main Authors: Yoshikane, Yukako, Mori, Toshiko, Yoshizato, Toshiyuki, Miyake, Yoshihiro, Hirose, Shinichi
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.07.2011; Springer; Springer Nature B.V
• Subjects: Aorta; Apgar score; Atria; Birth weight; Confidence intervals; Congenital diseases; Contraindications; Coronary vessels; Diameters; Diastole; Disease prevention; ELBWI; Failure; Gestational age; Health risks; Heart; Imaging; Indomethacin; Infants; Medicine; Medicine & Public Health; Newborn babies; Original Article; Patent ductus arteriosus; PDA diameter; PDA ligation; Premature babies; Radiology; Regression analysis; Steroids; Surgery; Ultrasound; Variables; Japan; PDA diameter; ELBWI; PDA ligation; Indomethacin; Gestational age
• ISSN: 1346-4523; 1613-2254
• DOI: 10.1007/s10396-011-0309-8

Purpose To identify risk factors related to the failure of indomethacin therapy and the need for surgical repair in patent ductus arteriosus (PDA) in extremely low-birth-weight (<1000 g) infants (ELBWI). Methods Study subjects were 36 ELBWI with PDA born at a single tertiary perinatal center. They were classified into those who required surgery due to failure of indomethacin treatment (surgical group, n  = 21) and those with effective indomethacin treatment (non-surgical group, n  = 15). The odds ratios (ORs) and 95% confidence intervals (95% CIs) for the relationship between selected risk factors and surgical treatment of PDA were calculated. Results Gestational age of <28 weeks and diameter of PDA of 2 mm or more were independent and significant determinants of the need for surgical repair of PDA (adjusted ORs [95% CIs] = 9.91 [1.16–84.48] and 24.80 [2.72–225.74], respectively). The need for surgical repair of PDA did not correlate with sex, birth weight, 1-min Apgar score, left atrium diameter/aortic diameter (LA/Ao), left ventricular internal dimension at end-diastole, prophylaxes with indomethacin, and total dosage of indomethacin. Conclusions Gestational age at birth of <28 weeks and diameter of PDA of 2 mm or more are determinants of failure of indomethacin treatment for PDA and the need for surgical repair.