Transcatheter closure of patent ductus arteriosus in very and extremely preterm infants: the Grenoble-Alpes University Hospital experience since 2015 and the comparison to the historical surgical cohort of 2010-2015

Abstract : Invasive closure strategy for Patent Ductus Arteriosus (PDA) in preterm infants after failure of medical therapies remains controversial. While surgical ligation (by lateral thoracotomy) is the gold standard, the percutaneous closure has developed in France as an alternative technique since 2014. Our objective is to compare the efficacity and the safety of both strategies, consecutively performed at the CHUGA over the period 2010-2018. All data were retrospectively collected from the computer database of the CHUGA. Between 2010 and 2015, 11 PDA were closed surgically, whereas11 were closed percutaneously (ADOIIAS device Abbott®) between 2015 and 2018. Mean age at the time of percutaneous closure was 47±30 days and mean weight was 1663±646g versus 33±18 days, p=0.21 and 1304±133g, p=0.12 for the surgical group. No death related to any procedure occurred. Per and post-procedural morbidity was higher in the surgical group: 1 subglottic stenosis, 1 vocal chords paralysis, 1 arytenoid ankylosis, 3 patients under long term enteral nutrition, versus 2 transient and regressive LPA stenosis, and 1 transient aortic flow acceleration in the percutaneous group. Mean post-closure time under invasive ventilation in the percutaneous group was 6.5±6 days versus 17±21 days, p=0.12 in the surgical group. We report our experience about the change of technique for PDA invasive closure in preterm infants at the CHUGA during two consecutive periods from 2010 to 2018. In our center, percutaneous closure appears as effective than surgical ligation in short and mid-term follow-up, with a very low rate of per and postprocedural complications. These data are consistent with those of the literature.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02078317
Contributor : Jean-Hugues Morneau <>
Submitted on : Monday, March 25, 2019 - 12:10:37 PM
Last modification on : Friday, March 29, 2019 - 2:38:34 AM
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Johanne Auriau. Transcatheter closure of patent ductus arteriosus in very and extremely preterm infants: the Grenoble-Alpes University Hospital experience since 2015 and the comparison to the historical surgical cohort of 2010-2015. Human health and pathology. 2019. ⟨dumas-02078317⟩

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