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Surgical ligation, not transcatheter closure, associated with a higher severity of bronchopulmonary dysplasia in extremely preterm infant intervened for patent ductus arteriosus
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  • Yu-Jen Wei,
  • Ying-Tzu Ju,
  • Min-Ling Hsieh,
  • Chung-Dann Kan,
  • Yung-Chieh Lin,
  • Jieh Neng Wang
Yu-Jen Wei
National Cheng Kung University Hospital

Corresponding Author:[email protected]

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Ying-Tzu Ju
National Cheng Kung University Hospital
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Min-Ling Hsieh
National Cheng Kung University Hospital
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Chung-Dann Kan
National Cheng Kung University Hospital
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Yung-Chieh Lin
National Cheng Kung University Hospital
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Jieh Neng Wang
National Cheng Kung University Hospital
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Objective: Patent ductus arteriosus (PDA) is a common complication among premature infants, and it may be responsible for prematurity-related complications, such as bronchopulmonary dysplasia (BPD). It is unclear whether different interventional methods contribute to the severity of BPD. To date, surgical ligation and the transcatheter approach have shown equal success in premature infants with hemodynamically significant PDA after medical treatment failure. Immediate improvement in the respiratory condition after transcatheter closure has been reported. However, the short-term pulmonary outcome has not been clarified yet. Methods: This retrospective study investigated infants born with a body weight less than 1000 g and underwent either surgical ligation or transcatheter closure of PDA in a single tertiary institution. The infants were divided into groups according to the type of procedure (surgical ligation or transcatheter occlusion). The primary outcome was the severity of BPD at discharge or at post-menstrual age of 36 weeks. The outcome was analyzed with logistic regression. Results: Forty-four patients met the inclusion criteria, and of these, 14 underwent transcatheter occlusion and 30 underwent surgical ligation. The overall birth body weight and gestational age ranges were not different. The univariate model revealed an association between the procedure type and BPD severity. The multivariate model confirmed associations of BPD severity with procedure type and severe respiratory distress syndrome requiring surfactant after adjusting for confounders. Conclusion: Compared with the transcatheter approach, surgery for PDA in extremely preterm infants is associated with severe BPD at discharge. Further large-scale studies are needed to determine the exact mechanism.
14 Sep 2022Submitted to Pediatric Pulmonology
14 Sep 2022Submission Checks Completed
14 Sep 2022Assigned to Editor
19 Sep 2022Reviewer(s) Assigned
04 Oct 2022Review(s) Completed, Editorial Evaluation Pending
05 Oct 2022Editorial Decision: Revise Major
19 Dec 20221st Revision Received
19 Dec 2022Assigned to Editor
19 Dec 2022Submission Checks Completed
19 Dec 2022Review(s) Completed, Editorial Evaluation Pending
19 Dec 2022Reviewer(s) Assigned
27 Dec 2022Editorial Decision: Revise Minor
30 Dec 20222nd Revision Received
04 Jan 2023Review(s) Completed, Editorial Evaluation Pending
04 Jan 2023Submission Checks Completed
04 Jan 2023Assigned to Editor
04 Jan 2023Reviewer(s) Assigned
19 Jan 2023Editorial Decision: Accept