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Transcatheter Closure vs. Surgical Ligation in Preterm Infants with Patent Ductus Arteriosus: A Systematic Review and Meta-Analysis

Rohan Suresh Daniel1,2, Georgia K. Schmidt1,2, Hayato Nakanishi1,2, Karen Smayra1,2, Mariah N. Mascara1,2, Dilip K. Vankayalapati1,2, Reem H. Matar1,2,3, Christian A. Than1,2,4, George Shiakos5, Ioannis Tzanavaros2,5,*

1 St George’s, University of London, London, UK
2 University of Nicosia Medical School, University of Nicosia, Nicosia, 2417, Cyprus
3 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, 55905, USA
4 School of Biomedical Sciences, The University of Queensland, St Lucia, Brisbane, 4072, Australia
5 Cardiac Innovation Center of Apollonion Private Hospital, Nicosia, Cyprus

* Corresponding Author: Ioannis Tzanavaros. Email: email

Congenital Heart Disease 2023, 18(2), 245-265. https://doi.org/10.32604/chd.2023.027596

Abstract

Background: Persistent patent ductus arteriosus (pPDA) is a common condition in preterm infants. This meta-analysis aimed to assess the safety and efficacy of transcatheter closure (TC) when compared to surgical ligation (SL) in preterm infants with pPDA. Methods: A literature search of Ovid Cochrane Library, Medline, Embase, Epub, Scopus, PMC Preprints, and was conducted from inception to May 06, 2022. Eligible studies reported infants diagnosed with pPDA born at ≤2000 g birth weight or at ≤37 weeks’ who underwent TC or SL as treatment. This review was registered in PROSPERO (CRD42022325944). Results: From 97 studies screened, 8 studies met the eligibility criteria, with a total of 756 preterm infants undergoing either TC (n = 366) or SL (n = 390). Compared to TC, SL had higher mortality rates (OR = 0.32, 95% CI: 0.16, 0.66, I2 = 0%). No difference was seen in post-procedural complication rate (OR = 0.90, 95% CI: 0.18, 4.44, I2 = 79%), mean duration of post-procedural mechanical ventilation (MD = −2.21 days, 95% CI: −4.88, 0.47, I2 = 60%), hospital stay length (MD = −8.30 days, 95% CI: −17.03, 0.44, I2 = 0%) or neonatal intensive care unit stay length (MD = −3.50 days, 95% CI: −10.27, 3.27, I2 = 0%). Conclusion: Our meta-analysis demonstrated TC as a viable alternative option in managing preterm infants with pPDA in the context of SL. Despite the promising trends demonstrated in this meta-analysis, further studies with larger sample size and controlled baseline characteristics are needed to evaluate the safety and efficacy of TC and SL for preterm infants with pPDA.

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Cite This Article

Daniel, R. S., Schmidt, G. K., Nakanishi, H., Smayra, K., Mascara, M. N. et al. (2023). Transcatheter Closure vs. Surgical Ligation in Preterm Infants with Patent Ductus Arteriosus: A Systematic Review and Meta-Analysis. Congenital Heart Disease, 18(2), 245–265.



cc This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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