초록접수 현황
| 17F-065 | English competition forum |
Early Surgical Closure of Patent Ductus Arteriosus in Preterm Neonates
Yoonjin Kang, Jae Gun Kwak, Eungrae Kim, Jeong Ryeol Lee, Woong-Han Kim
Department of Thoracic & Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Surgical intervention of patent ductus arteriosus (PDA) is done when pharmacological treatment is contraindicated or fails; however, it remains unclear exactly when to perform surgery. Thus, we attempt to evaluate the outcome of surgical treatment for PDA in preterm neonates according to the age at operation and the preoperative pharmacological treatment.
Methods : We evaluated 117 symptomatic preterm neonates who underwent surgical correction for PDA from April 2010 to Dec 2016. In-hospital outcomes of the treatment and predictors of mortality were evaluated according to the timing of the surgery (the age at operation ≤10 days versus > 10 days). For subgroup analysis, we also divided each group into two groups: primary surgical closure group and secondary closure group who received surgery following medical failure.
Results : Late group was associated with increased incidence in bronchopulmonary dysplasia (Odds ratio (OR) 3.354, p=0.017) and pneumonia (OR 4.075, p=0.065). In subgroup analysis, early primary surgical closure group was significantly associated with fewer bronchopulmonary dysplasia (OR 0.625, p=0.004) and pneumonia (OR 0.304, p=0.023). Presence of bronchopulmonary dysplasia and pneumonia were significantly associated with an increased risk of mortality in symptomatic neonates. There was no immediate intraoperative operative mortality or complication.
Conclusion : Early occlusion (age at operation ≤ 10 days) of PDA in symptomatic preterm neonates is associated with fewer incidence of pulmonary complications. As pulmonary complications were associated with an increased risk for mortality, early surgical closure of PDA when indicated may improve respiratory outcomes of symptomatic preterm neonates with an acceptable safety.
Methods : We evaluated 117 symptomatic preterm neonates who underwent surgical correction for PDA from April 2010 to Dec 2016. In-hospital outcomes of the treatment and predictors of mortality were evaluated according to the timing of the surgery (the age at operation ≤10 days versus > 10 days). For subgroup analysis, we also divided each group into two groups: primary surgical closure group and secondary closure group who received surgery following medical failure.
Results : Late group was associated with increased incidence in bronchopulmonary dysplasia (Odds ratio (OR) 3.354, p=0.017) and pneumonia (OR 4.075, p=0.065). In subgroup analysis, early primary surgical closure group was significantly associated with fewer bronchopulmonary dysplasia (OR 0.625, p=0.004) and pneumonia (OR 0.304, p=0.023). Presence of bronchopulmonary dysplasia and pneumonia were significantly associated with an increased risk of mortality in symptomatic neonates. There was no immediate intraoperative operative mortality or complication.
Conclusion : Early occlusion (age at operation ≤ 10 days) of PDA in symptomatic preterm neonates is associated with fewer incidence of pulmonary complications. As pulmonary complications were associated with an increased risk for mortality, early surgical closure of PDA when indicated may improve respiratory outcomes of symptomatic preterm neonates with an acceptable safety.
첨부파일 : pda_KTCVS_0818.pptx
책임저자: Jae Gun Kwak
Department of Thoracic & Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Yoonjin Kang, E-mail : yoonjin.r.kang@gmail.com