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Nguyen TT, Nguyen DTN, Pham TTT, Oei JL. Prophylaxis of Patent Ductus Arteriosus with Paracetamol in Extremely Low Gestational Age Newborns (ELGANs): A Single-Institution Observational Study in Vietnam. Children (Basel) 2023; 10:1934. [PMID: 38136136 PMCID: PMC10741618 DOI: 10.3390/children10121934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Prophylactic paracetamol for extremely low gestation age neonates (ELGAN, <27 weeks' gestation) with symptomatic patent ductus arteriosus (sPDA) in high-income countries (HIC) reduces medical and surgical interventions. Its effectiveness in low-to-middle-income countries (LMIC) remains uncertain. This study assesses prophylactic paracetamol's impact on sPDA interventions in ELGANs in an LMIC. METHODS This is a retrospective cohort study that compared a historical cohort of ELGANs that were treated with oral ibuprofen or intravenous paracetamol after diagnosis of sPDA (n = 104) with infants (n = 76) treated with prophylactic paracetamol (20 mg/kg loading, 7.5 mg/kg qid for 4 days), in a tertiary neonatal intensive care unit (NICU) in Vietnam. Oral ibuprofen or intravenous therapeutic paracetamol were administered if prophylactic paracetamol failed to close sPDA. Surgical ligation was conducted if targeted medical intervention failed, or the infant deteriorated from conditions attributable to sPDA. RESULTS In the historical cohort, 57 (55%) infants died within 7 days of life compared to 18 (24%) from the prophylactic cohort (p < 0.01). Of the survivors, 21 (45%) of the historical and 23 (39.7%) of the prophylactic cohort required surgical ligation (p = 0.6). Duration of hospitalization for survivors was lower in the prophylactic cohort (mean 74 vs. 97 days, p = 0.01). In the prophylactic cohort, 24 (41%) infants did not need further treatment while 34 (59%) required further treatment including ibuprofen and/or paracetamol 28 (48%) and surgical ligation 22 (38%). CONCLUSIONS Prophylactic paracetamol for ELGAN in LMIC does not reduce the need for surgical ligation, sPDA rates, and other PDA-related morbidities in infants who survive beyond 7 days of age. It may reduce the risk of death and the duration of hospitalization but further study into the reasons behind this need to be determined with larger studies.
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Affiliation(s)
- Tinh Thu Nguyen
- Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam;
- Neonatal Intensive Care Unit, Children’s Hospital 2, Ho Chi Minh City 700000, Vietnam
| | - Dung Thi Ngoc Nguyen
- Pediatric and Neonatology Department, Franco-Vietnamese Hospital, Ho Chi Minh City 700000, Vietnam;
| | - Tam Thi Thanh Pham
- Neonatal Intensive Care Unit, Children’s Hospital 1, Ho Chi Minh City 700000, Vietnam;
| | - Ju-Lee Oei
- School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
- Department of Newborn Care, The Royal Hospital for Women, Randwick, Sydney, NSW 2031, Australia
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Najmafshar L, Abdolhosseini M, Tanasan A, Abdolhosseini M, Hosseini SK. Multimodality imaging in diagnosis and management of patent ductus arteriosus in an adult: a case report. Am J Cardiovasc Dis 2023; 13:272-277. [PMID: 37736355 PMCID: PMC10509450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
Patent ductus arteriosus (PDA) is a congenital heart disorder in which a vascular structure between the pulmonary artery and the aorta remains open. PDA normally closes shortly after birth. The treatment in adults is surgical or transcatheter closure. A 47-year-old woman presented to our hospital with a diagnosis of PDA and was treated with transcatheter closure. Although the recovery period of adult patients is long, this patient recovered completely after one day.
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Affiliation(s)
- Leila Najmafshar
- Department of Cardiology, School of Medicine, Hamadan University of Medical SciencesHamadan, Iran
| | - Mansoreh Abdolhosseini
- Department of Molecular Medicine, School of Advanced Medical Technologies, Tehran University of Medical SciencesTehran, Iran
| | - Asadolah Tanasan
- Department of Pediatrics, Faculty of Medicine, Hamadan University of Medical SciencesHamadan, Iran
| | - Masoumeh Abdolhosseini
- Department of Cardiology, School of Medicine, Hamadan University of Medical SciencesHamadan, Iran
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Bruckheimer E, Steiner K, Barak-Corren Y, Slanovic L, Levinzon M, Lowenthal A, Amir G, Dagan T, Birk E. The Amplatzer duct occluder (ADOII) and Piccolo devices for patent ductus arteriosus closure: a large single institution series. Front Cardiovasc Med 2023; 10:1158227. [PMID: 37215550 PMCID: PMC10193946 DOI: 10.3389/fcvm.2023.1158227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/10/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Evaluate Piccolo and ADOII devices for transcatheter patent ductus arteriosus (PDA) closure. Piccolo has smaller retention discs reducing risk of flow disturbance but residual leak and embolization risk may increase. Methods Retrospective review of all patients undergoing PDA closure with an Amplatzer device between January 2008 and April 2022 in our institution. Data from the procedure and 6 months follow-up were collected. Results 762 patients, median age 2.6 years (range 0-46.7) years and median weight 13 kg (range 3.5-92) were referred for PDA closure. Overall, 758 (99.5%) had successful implantation: 296 (38.8%) with ADOII, 418 (54.8%) with Piccolo, and 44 (5.8%) with AVPII. The ADOII patients were smaller than the Piccolo patients (15.8 vs. 20.5 kg, p < 0.001) and with larger PDA diameters (2.3 vs. 1.9 mm, p < 0.001). Mean device diameter was similar for both groups. Closure rate at follow-up was similar for all devices ADOII 295/296 (99.6%), Piccolo 417/418 (99.7%), and AVPII 44/44 (100%). Four intraprocedural embolizations occurred during the study time period: two ADOII and two Piccolo. Following retrieval the PDA was closed with an AVPII in two cases, ADOI in one case and with surgery in the fourth case. Mild stenosis of the left pulmonary artery (LPA) occurred in three patients with ADOII devices (1%) and one patient with Piccolo device (0.2%). Severe LPA stenosis occurred in one patient with ADOII (0.3%) and one with AVPII device (2.2%). Conclusions ADOII and Piccolo are safe and effective for PDA closure with a tendency to less LPA stenosis with Piccolo. There were no cases of aortic coarctation related to a PDA device in this study.
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Affiliation(s)
- Elchanan Bruckheimer
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Kristoffer Steiner
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Yuval Barak-Corren
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Leonel Slanovic
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Michael Levinzon
- Section of Pediatric Anesthesiology, Schneider Children’s, Medical Center of Israel, Petach Tikva, Israel
| | - Alexander Lowenthal
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Gabriel Amir
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Tamir Dagan
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
| | - Einat Birk
- Section of Pediatric Cardiology, Schneider Children’s Medical, Center of Israel, Petach Tikva, Israel
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Stącel T, Sybila P, Mędrala A, Ochman M, Latos M, Zawadzki F, Pióro A, Pasek P, Przybyłowski P, Hrapkowicz T, Mroczek E, Kuczaj A, Kopeć G, Fiszer R, Pawlak S, Stanjek-Cichoracka A, Urlik M. Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA). J Cardiovasc Dev Dis 2022; 9:jcdd9120457. [PMID: 36547454 PMCID: PMC9783473 DOI: 10.3390/jcdd9120457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Patients with pulmonary arterial hypertension (PAH) become candidates for lung or lung and heart transplantation when the maximum specific therapy is no longer effective. The most difficult challenge is choosing one of the above options in the event of symptoms of right ventricular failure. Here, we present two female patients with PAH: (1) a 21-year-old patient with Eisenmenger syndrome, caused by a congenital defect-patent ductus arteriosus (PDA); and (2) a 39-year-old patient with idiopathic PAH and coexistent PDA. Their common denominator is PDA and the hybrid surgery performed: double lung transplantation with simultaneous PDA closure. The operation was performed after pharmacological bridging (conditioning) to transplantation that lasted for 33 and 70 days, respectively. In both cases, PDA closure effectiveness was 100%. Both patients survived the operation (100%); however, patient no. 1 died on the 2nd postoperative day due to multi-organ failure; while patient no. 2 was discharged home in full health. The authors did not find a similar description of the operation in the available literature and PubMed database. Hence, we propose this new treatment method for its effectiveness and applicability proven in our practice.
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Affiliation(s)
- Tomasz Stącel
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence: (T.S.); (A.M.); Tel.: +48-691-045-785 (T.S.); +48-731-832-083 (A.M.)
| | - Paweł Sybila
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Agata Mędrala
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence: (T.S.); (A.M.); Tel.: +48-691-045-785 (T.S.); +48-731-832-083 (A.M.)
| | - Marek Ochman
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Magdalena Latos
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Fryderyk Zawadzki
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Anna Pióro
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac Anaesthesia and Intensive Care, Medical University of Silesia, 40-055 Katowice, Poland
| | - Piotr Pasek
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Piotr Przybyłowski
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
- First Department of General Surgery, Collegium Medicum of Jagiellonian University, 30-688 Krakow, Poland
| | - Tomasz Hrapkowicz
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Ewa Mroczek
- Institute of Heart Diseases, University Clinical Hospital Mikulicz Radecki in Wroclaw, ul. Borowska 213, 50-558 Wroclaw, Poland
| | - Agnieszka Kuczaj
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Grzegorz Kopeć
- Pulmonary Circulation Centre, Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland
| | - Roland Fiszer
- Silesian Centre for Heart Diseases in Zabrze, Department of Congenital Heart Defects and Pediatric Cardiology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Szymon Pawlak
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Anita Stanjek-Cichoracka
- Department of Biophysics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jedności 8, 41-200 Sosnowiec, Poland
| | - Maciej Urlik
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
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Alakhfash AA, Alqwaiee A, Alakhfash GA, Alhajjaj A, Almesned AA. Pulmonary hypertension associated with congenital heart disease; clinical decision scenario. Respir Med Case Rep 2020; 31:101286. [PMID: 33294357 PMCID: PMC7683341 DOI: 10.1016/j.rmcr.2020.101286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/18/2020] [Accepted: 11/07/2020] [Indexed: 11/26/2022] Open
Abstract
Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is one type under group 1 PH. Undiagnosed or delayed diagnosis of significant CHD might lead to significant PAH and at the end might lead to Eisenmenger syndrome. We could expect the degree of PAH in patients with CHD by proper clinical assessment as well as by the basic assessment tools including the chest x-ray (CXR), ECG, and transthoracic echocardiography (TTE). We are presenting a three and half years old child with a delayed/missed diagnosis of large patent ductus arteries (PDA) who present with significant PAH. Clinical evaluation, CXR, ECG, TTE, as well as cardiac catheterization data are presented, with a review of the current guidelines regarding the management of pediatric patients with PAH-CHD.
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Key Words
- APW, Aortopulmonary window
- BPD, Bronchopulmonary dysplasia
- CHD, Congenital Heart Disease
- Congenital heart defects
- PAH, Pulmonary arterial hypertension
- PCW, pulmonary capillary wedge
- PDA closure
- PDA, Patent ductus arteriosus
- PH, Pulmonary hypertension
- PVR, pulmonary vascular resistance
- Pulmonary arterial hypertension
- Qp, pulmonary blood flow
- Qs, Systemic blood flow
- SVR, Systemic vascular resistance
- VSD, Ventricular septal defect
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Affiliation(s)
- Ali A Alakhfash
- Consultant Pediatric Cardiologist, Prince Sultan Cardiac Center-Qassim, Saudi Arabia
| | - Abdullah Alqwaiee
- Consultant Pediatric Cardiologist, Prince Sultan Cardiac Center-Qassim, Saudi Arabia
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Fridman E, Mangel L, Mandel D, Beer G, Kapusta L, Marom R. Effects of maternal aspirin treatment on hemodynamically significant patent ductus arteriosus in preterm infants - pilot study. J Matern Fetal Neonatal Med 2020; 35:958-963. [PMID: 32138560 DOI: 10.1080/14767058.2020.1736028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: To assess the burden of hemodynamically significant patent ductus arteriosus (hs-PDA) in preterm infants exposed to aspirin in utero.Methods: We retrospectively reviewed the medical records of 21 preterm infants <34 weeks whose mothers were treated with aspirin during gestation, and were screened for patent ductus arteriosus due to severe respiratory distress syndrome and the need for positive pressure ventilation. These infants were compared to 42 preterm infants born without exposure to aspirin in utero.Results: We found significantly lower frequency of hs-PDA and higher rate of successful pharmacological PDA closure after single course of ibuprofen treatment along with significantly lower cumulative doses of ibuprofen in the study group. Furthermore, PDA closure was achieved significantly earlier in the study group (day 4 versus 11, p = .02).Conclusion: Aspirin treatment during pregnancy seemed to reduce the incidence of hs-PDA in preterm infant and to increase infant responsiveness to postnatal medical treatment of PDA.
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Affiliation(s)
- Elena Fridman
- Department of Neonatology, Assuta Medical Center, Ashdod, Israel.,Be'er Sheva School of Medicine, Ben Gurion University of the Negev, Beersheba, Israel
| | - Laurence Mangel
- Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dror Mandel
- Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Beer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Cardiology Unit, Dana-Dwek Children Hospital, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
| | - Livia Kapusta
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Cardiology Unit, Dana-Dwek Children Hospital, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel.,Department of Pediatric Cardiology, Radboud University Medical Centre, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Ronella Marom
- Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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El-Mashad AER, El-Mahdy H, El Amrousy D, Elgendy M. Comparative study of the efficacy and safety of paracetamol, ibuprofen, and indomethacin in closure of patent ductus arteriosus in preterm neonates. Eur J Pediatr 2017; 176:233-240. [PMID: 28004188 DOI: 10.1007/s00431-016-2830-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 02/08/2023]
Abstract
UNLABELLED In this prospective study, we compared the efficacy and side effects of indomethacin, ibuprofen, and paracetamol in patent ductus arteriosus (PDA) closure in preterm neonates. Three hundred preterm neonates with hemodynamically significant PDA (hs-PDA) admitted at our neonatal intensive care unit were enrolled in the study. They were randomized into three groups. Group I (paracetamol group) received 15 mg/kg/6 h IV paracetamol infusion for 3 days. Group II (ibuprofen group) received 10 mg/kg IV ibuprofen infusion followed by 5 mg/kg/day for 2 days. Group III (indomethacin group) received 0.2 mg/kg/12 h indomethacin IV infusion for three doses. Laboratory investigations such as renal function test, liver function test, complete blood count, and blood gases were conducted in addition to echocardiographic examinations. All investigations were done before and 3 days after treatment. There was no significant difference between all groups regarding efficacy of PDA closure (P = 0.868). There was a significant increase in serum creatinine levels and serum blood urea nitrogen (BUN) in the ibuprofen and indomethacin groups (P < 0.001). There was a significant reduction in platelet count and urine output (UOP) in both ibuprofen and indomethacin groups (P < 0.001). There was a significant increase in bilirubin levels in only the ibuprofen group (P = 0.003). No significant difference of hemoglobin (HB) level or liver enzymes in all groups (P > 0.05). Ventilatory settings improved significantly in patients with successful closure of PDA than those with failed PDA closure (P < 0.001). CONCLUSION Paracetamol is as effective as indomethacin and ibuprofen in closure of PDA in preterm neonates and has less side effects mainly on renal function, platelet count, and GIT bleeding. What is Known: • Hemodynamically significant patent ductus arteriosus has many complications for preterm and low birth weight neonates and better to be closed. Many drugs were used for medical closure of PDA e.g. indomethacin, ibuprofen and recently paracetamol. Many studies compare safety and efficacy of paracetamol with either indomethacin or ibuprofen. What is New: • It is the first large study that compares the efficacy and side effects of the three drugs in one study.
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MESH Headings
- Acetaminophen/administration & dosage
- Acetaminophen/adverse effects
- Acetaminophen/therapeutic use
- Analgesics, Non-Narcotic/administration & dosage
- Analgesics, Non-Narcotic/adverse effects
- Analgesics, Non-Narcotic/therapeutic use
- Analysis of Variance
- Cyclooxygenase Inhibitors/administration & dosage
- Cyclooxygenase Inhibitors/adverse effects
- Cyclooxygenase Inhibitors/therapeutic use
- Ductus Arteriosus, Patent/diagnostic imaging
- Ductus Arteriosus, Patent/drug therapy
- Female
- Gestational Age
- Humans
- Ibuprofen/administration & dosage
- Ibuprofen/adverse effects
- Ibuprofen/therapeutic use
- Indomethacin/administration & dosage
- Indomethacin/adverse effects
- Indomethacin/therapeutic use
- Infant, Extremely Premature
- Infant, Newborn
- Infant, Very Low Birth Weight
- Infusions, Intravenous
- Intensive Care Units, Neonatal
- Male
- Prospective Studies
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Affiliation(s)
| | - Heba El-Mahdy
- Pediatric Department, Tanta University Hospital, Elgeish street, Tanta, Egypt
| | - Doaa El Amrousy
- Pediatric Department, Tanta University Hospital, Elgeish street, Tanta, Egypt.
| | - Marwa Elgendy
- Pediatric Department, Tanta University Hospital, Elgeish street, Tanta, Egypt
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Bansal NO, Prabhu S, Ware D, Shivapuje SK. Transcathater percutaneous device closure of a large PDA closed in a 3 kg infant. Indian Heart J 2014; 66:707-9. [PMID: 25634411 DOI: 10.1016/j.ihj.2014.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/26/2014] [Accepted: 12/03/2014] [Indexed: 11/16/2022] Open
Abstract
Patent ductus arteriosus (PDA) is common congenital heart disease which may require treatment as transcatheter percutaneous device closure (PDA device closure) or surgical ligation in symptomatic full-term patients. Surgical ligation is an invasive procedure and has more complications especially in the neonates. Problems in PDA device closure are difficult vascular access, manipulation of catheters and sheath, residual shunts, residual obstruction of major arteries etc and these complications increase in low birth weight babies, but it is a less invasive procedure and has fewer complications than surgery, so should be tried in low birth weight patients also. We are presenting a case of 3 kg infant with large PDA (8 mm) presented with failure to thrive, lower respiratory tract infection and heart failure. He successfully underwent PDA device closure with 10 × 12 mm Cocoon PDA device. To the best of our knowledge, this is the first case of the use of such a large device in a 3 kg child with good results.
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Affiliation(s)
- N O Bansal
- Prof. & HOD, Dept. of Cardiology, Grant Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai 400008, India; Asst. Prof., Dept. of Cardiology, Grant Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai 400008, India; Secretary, Cardiology Society of India (Mumbai Branch), India; Faculty, TCT, Asia Pacific 2009, South Korea; Interventional Cardiologist, Cumballa Hill Hospital, Mumbai, India
| | - Sandesh Prabhu
- Asst. Prof., Dept. of Cardiology, Grant Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai 400008, India
| | - Dhananjay Ware
- D. M. Resident, Dept. of Cardiology, Grant Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai 400008, India.
| | - Sanjaykumar K Shivapuje
- Asst. Prof., Dept. of Cardiology, Grant Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai 400008, India
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Ghanem S, Mostafa M, Shafee M. Effect of oral ibuprofen on patent ductus arteriosus in premature newborns. J Saudi Heart Assoc 2010; 22:7-12. [PMID: 23960586 DOI: 10.1016/j.jsha.2010.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Accepted: 12/30/2009] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AIM OF THE STUDY Patent ductus arteriosus (PDA), a common finding among premature infants, is conventionally treated by intravenous indomethacin. Intravenous ibuprofen was recently shown to be as effective and to have fewer adverse reactions in preterm infants. If equally effective, then oral ibuprofen for PDA closure would have several important advantages over the intravenous route. This study was designed to determine whether oral ibuprofen treatment is efficacious and safe in closure of a PDA in premature infants. PATIENTS AND METHODS Thirty-three premature group I (study group) were treated with ibuprofen 10 mg/kg administered through a feeding tube. Thirty-three premature group II (control group) receive placebo the two imaging procedures were again performed 24 h after each ibuprofen dose. When the PDA was still hemodynamically significant, as demonstrated by echocardiography, and there was no evidence of deterioration in brain ultrasonography, a second dose of ibuprofen 5 mg/kg (placebo for control) was administered. A third equivalent dose was given after another 24 h if necessary. Cranial ultrasound was repeated 1 week after the last ibuprofen dose and again before discharge from the ward. Hematochemical analysis was preformed daily in the unit during the first days of life. RESULTS In the study group the rate of PDA closure was 93.9% (31 of 33 cases) while in the control group the rate of PDA closure was 30.3% (10 of 33 cases) with significant difference in between. There was no reopening of the ductus after closure had been achieved. No infant required surgical ligation of the ductus in study group while in the control group 24.2% (8 of 33 cases) were required surgical ligation (Table 2). Twenty-one newborns were treated with 1 dose of ibuprofen, 9 were treated with 2 doses, and the remaining 3 were treated with 3 doses. CONCLUSION Oral ibuprofen is an effective and safe alternative to intravenous ibuprofen for PDA closure in premature infants.
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Affiliation(s)
- Sabry Ghanem
- Department of Pediatrics, Alazhar University, Cairo, Egypt
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