Extremely premature infants with patent ductus arteriosus closure Comparative analysis of surgical ligation versus cardiac catheterization-based closure

Our objective was to compare postprocedure hemodynamic decompensation in extremely premature infants who had their patent ductus arteriosus (PDA) closed with surgical ligation (SL) versus cardiac catheter-based closure (CCC). This is a single-center retrospective review of extremely premature ( < 28 weeks) infants who had their PDA closed by SL or CCC. Of the total of 69 infants, 53 underwent SL, and 16 had CCC. Infants in 2 groups were comparable at birth. However, at the time of the procedure, infants in the SL group were smaller, less mature, and had higher respiratory support. Vasopressor use, both pre- and postprocedure, was more common in the SL group. Nineteen percent of the infants in the SL group, compared to 6% in the CCC group (P = .34), required dose escalation or use of vasopressors after the PDA closure. There was no significant difference between the 2 groups in postoperative hemodynamic decompensation. Large, multicenter, prospective study or randomized control trial will help to confirm our findings.