Percutaneous closure of patent ductus arteriosus versus surgical ligation in preterm infants: A retrospective study

Objective The aim of the study was to compare the short-term outcome after patent ductus arteriosus (PDA) percutaneous closure versus surgical ligation in extremely preterm infants. Methods We retrospectively performed a mono-centric matched case-control study. Cases were preterm infants born before 28 weeks of gestation with PDA percutaneous closure performed in Nantes University hospital. Each case was matched, for gestational age and post-natal age at intervention, with 2 controls who had PDA surgical ligation. The main criterion was the rate of extubated patients 2 days after the procedure. Results We included in the analysis 14 percutaneous closures and 28 surgical ligations performed between January 2006 and December 2017. Two days after the procedure, 7.1% patients were off mechanical ventilation in the surgical group versus 50% in the percutaneous group ( P  = 0.001). Mean duration of mechanical ventilation was 5.4 days (± 5.0) in the percutaneous group versus 12.5 days (± 11.1) in the surgical group ( P  = 0.009). No complication of percutaneous closure was noticed. Conclusion Percutaneous closure of PDA allowed a faster pulmonary recovery and mechanical ventilation cessation in preterm infant born before 28 weeks of gestation with the same efficacy and without any related complication than surgery.