Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants

Introduction: Patent ductus arteriosus (PDA) is common in preterm infants and contributes to morbidity and mortality. Several studies have shown the feasibility and safety of percutaneous PDA closure. Minimally invasive surgical ligation by anterior thoracotomy is an alternative, bedside technique f...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Marien Lenoir, Chloé Wanert, Damien Bonnet, Mathilde Méot, Barthélémy Tosello, Virginie Fouilloux, Caroline Ovaert, Sophie Malekzadeh-Milani
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	transcatheter closure mini-invasive surgery prematurity patent ductus arteriosus very low birth weight preterm infant Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/a8421274a0694d2d8c6055406750f292
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a8421274a0694d2d8c6055406750f292
record_format	dspace
spelling	oai:doaj.org-article:a8421274a0694d2d8c6055406750f2922021-11-19T07:51:37ZAnterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants2296-236010.3389/fped.2021.700284https://doaj.org/article/a8421274a0694d2d8c6055406750f2922021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.700284/fullhttps://doaj.org/toc/2296-2360Introduction: Patent ductus arteriosus (PDA) is common in preterm infants and contributes to morbidity and mortality. Several studies have shown the feasibility and safety of percutaneous PDA closure. Minimally invasive surgical ligation by anterior thoracotomy is an alternative, bedside technique for PDA closure in very low birth weight preterm infants. Our study aimed to compare short- and medium-term morbidity and mortality between anterior minithoracotomy and transcatheter PDA closure.Methods: From 2010 to 2020, 92 preterm infants <1,600 g underwent PDA closure in two centers: 44 surgical anterior minithoracotomies (center 1) and 48 transcatheter closures (center 2). Using a 1:1 propensity score match analysis, 22 patients in each group were included. The primary outcome was time to extubation after intervention.Results: Preoperative characteristics were similar in both groups after propensity matching (mean weight at procedure, 1,171 ± 183 g; p = 0.8). Mean time to extubation was similar: 10 ± 15 days in the surgical group vs. 9 ± 13 days in the transcatheter group (p = 0.9). Mean age at hospital discharge was 114 ± 29 days vs. 105 ± 19 days (p = 0.2). Two deaths occurred in the surgical group and one in the transcatheter group (p = 0.61). Five complications (pneumothorax n = 2, chylothorax n = 2, phrenic nerve injury n = 1) occurred in three patients after surgery. Three complications (chylothorax n = 1, endocarditis n = 1, renal vein thrombosis n = 1) occurred in two patients after percutaneous closure (p = 0.63).Conclusion: Equivalent efficiency and safety of surgical mini-invasive vs. transcatheter PDA closure in preterm infants <1,600 g are in favor of applying these alternative techniques according to centers' facilities and competences.Marien LenoirChloé WanertDamien BonnetDamien BonnetMathilde MéotBarthélémy ToselloBarthélémy ToselloVirginie FouillouxCaroline OvaertCaroline OvaertSophie Malekzadeh-MilaniFrontiers Media S.A.articletranscatheter closuremini-invasive surgeryprematuritypatent ductus arteriosusvery low birth weight preterm infantPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	transcatheter closure mini-invasive surgery prematurity patent ductus arteriosus very low birth weight preterm infant Pediatrics RJ1-570
spellingShingle	transcatheter closure mini-invasive surgery prematurity patent ductus arteriosus very low birth weight preterm infant Pediatrics RJ1-570 Marien Lenoir Chloé Wanert Damien Bonnet Damien Bonnet Mathilde Méot Barthélémy Tosello Barthélémy Tosello Virginie Fouilloux Caroline Ovaert Caroline Ovaert Sophie Malekzadeh-Milani Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants
description	Introduction: Patent ductus arteriosus (PDA) is common in preterm infants and contributes to morbidity and mortality. Several studies have shown the feasibility and safety of percutaneous PDA closure. Minimally invasive surgical ligation by anterior thoracotomy is an alternative, bedside technique for PDA closure in very low birth weight preterm infants. Our study aimed to compare short- and medium-term morbidity and mortality between anterior minithoracotomy and transcatheter PDA closure.Methods: From 2010 to 2020, 92 preterm infants <1,600 g underwent PDA closure in two centers: 44 surgical anterior minithoracotomies (center 1) and 48 transcatheter closures (center 2). Using a 1:1 propensity score match analysis, 22 patients in each group were included. The primary outcome was time to extubation after intervention.Results: Preoperative characteristics were similar in both groups after propensity matching (mean weight at procedure, 1,171 ± 183 g; p = 0.8). Mean time to extubation was similar: 10 ± 15 days in the surgical group vs. 9 ± 13 days in the transcatheter group (p = 0.9). Mean age at hospital discharge was 114 ± 29 days vs. 105 ± 19 days (p = 0.2). Two deaths occurred in the surgical group and one in the transcatheter group (p = 0.61). Five complications (pneumothorax n = 2, chylothorax n = 2, phrenic nerve injury n = 1) occurred in three patients after surgery. Three complications (chylothorax n = 1, endocarditis n = 1, renal vein thrombosis n = 1) occurred in two patients after percutaneous closure (p = 0.63).Conclusion: Equivalent efficiency and safety of surgical mini-invasive vs. transcatheter PDA closure in preterm infants <1,600 g are in favor of applying these alternative techniques according to centers' facilities and competences.
format	article
author	Marien Lenoir Chloé Wanert Damien Bonnet Damien Bonnet Mathilde Méot Barthélémy Tosello Barthélémy Tosello Virginie Fouilloux Caroline Ovaert Caroline Ovaert Sophie Malekzadeh-Milani
author_facet	Marien Lenoir Chloé Wanert Damien Bonnet Damien Bonnet Mathilde Méot Barthélémy Tosello Barthélémy Tosello Virginie Fouilloux Caroline Ovaert Caroline Ovaert Sophie Malekzadeh-Milani
author_sort	Marien Lenoir
title	Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants
title_short	Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants
title_full	Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants
title_fullStr	Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants
title_full_unstemmed	Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants
title_sort	anterior minithoracotomy vs. transcatheter closure of patent ductus arteriosus in very preterm infants
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a8421274a0694d2d8c6055406750f292
work_keys_str_mv	AT marienlenoir anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT chloewanert anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT damienbonnet anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT damienbonnet anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT mathildemeot anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT barthelemytosello anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT barthelemytosello anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT virginiefouilloux anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT carolineovaert anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT carolineovaert anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants AT sophiemalekzadehmilani anteriorminithoracotomyvstranscatheterclosureofpatentductusarteriosusinverypreterminfants
_version_	1718420278457925632

Anterior Minithoracotomy vs. Transcatheter Closure of Patent Ductus Arteriosus in Very Preterm Infants

Ejemplares similares