TY - JOUR
T1 - A Global Perspective on PDA Management in the Extremely Premature
T2 - Shifting Trend Toward Transcatheter Closure
AU - Sathanandam, Shyam
AU - McNamara, Patrick
AU - Pedra, Carlos
AU - Toyoshima, Katsuaki
AU - Malekzadeh-Milani, Sophie
AU - Patkai, Juliana
AU - Baspinar, Osman
AU - Uslu, Hasan Sinan
AU - Promphan, Worakan
AU - Khorana, Meera
AU - Wang, Jieh Neng
AU - Lin, Yung Chieh
AU - Fujii, Takanari
AU - Mainzer, Gur
AU - Salazar-Lizárraga, David
AU - Márquez-Gonzalez, Horacio
AU - Popat, Himanshu
AU - Mervis, Jonathan
AU - Hong, Neoh Siew
AU - Alwi, Mazeni
AU - Wonwandee, Ratthapon
AU - Schranz, Dietmar
AU - Stanimir, Georgiev
AU - Philip, Ranjit
AU - Ing, Frank
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Patent ductus arteriosus (PDA) is a frequently encountered defect in infants born extremely premature (≤26 weeks’ gestation). Historically, closure of the PDA was performed using cyclooxygenase inhibitor medications or by surgical ligations. However, the benefits of PDA closure using these therapies have never been demonstrated, albeit studies have previously not focused on the extremely premature infants. Therefore, there was a worldwide trend toward conservative management of the PDA. With improved survival of extremely premature infants, comorbidities associated with the PDA has increased, resulting in finding alternate treatments such as transcatheter patent ductus arteriosus closure (TCPC) for this population. Currently, there is a renewed interest toward selective treatment of the PDA in this high-risk cohort of small infants. This Comprehensive Review article inspects the globally changing trends in the management of the PDA in premature infants, with a special focus on the rising adoption of TCPC. Moreover, this article compiles data from several neonatal networks worldwide to help understand the problem at hand. Understanding the current management of premature infants and their outcomes is fundamentally essential if pediatric cardiologists are to offer TCPC as a viable therapeutic option for this population. This article aims to serve as a guide for pediatric cardiologists on this topic by compiling the results on landmark clinical trials on PDA management and the controversies that arise from these trials. Comparative outcomes from several countries are presented, including interpretations and opinions of the data from experts globally. This is a step toward coming to a global consensus in PDA management in premature infants.
AB - Patent ductus arteriosus (PDA) is a frequently encountered defect in infants born extremely premature (≤26 weeks’ gestation). Historically, closure of the PDA was performed using cyclooxygenase inhibitor medications or by surgical ligations. However, the benefits of PDA closure using these therapies have never been demonstrated, albeit studies have previously not focused on the extremely premature infants. Therefore, there was a worldwide trend toward conservative management of the PDA. With improved survival of extremely premature infants, comorbidities associated with the PDA has increased, resulting in finding alternate treatments such as transcatheter patent ductus arteriosus closure (TCPC) for this population. Currently, there is a renewed interest toward selective treatment of the PDA in this high-risk cohort of small infants. This Comprehensive Review article inspects the globally changing trends in the management of the PDA in premature infants, with a special focus on the rising adoption of TCPC. Moreover, this article compiles data from several neonatal networks worldwide to help understand the problem at hand. Understanding the current management of premature infants and their outcomes is fundamentally essential if pediatric cardiologists are to offer TCPC as a viable therapeutic option for this population. This article aims to serve as a guide for pediatric cardiologists on this topic by compiling the results on landmark clinical trials on PDA management and the controversies that arise from these trials. Comparative outcomes from several countries are presented, including interpretations and opinions of the data from experts globally. This is a step toward coming to a global consensus in PDA management in premature infants.
UR - http://www.scopus.com/inward/record.url?scp=85163452172&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85163452172&partnerID=8YFLogxK
U2 - 10.1016/j.jscai.2023.100968
DO - 10.1016/j.jscai.2023.100968
M3 - Review article
AN - SCOPUS:85163452172
SN - 2772-9303
VL - 2
JO - Journal of the Society for Cardiovascular Angiography and Interventions
JF - Journal of the Society for Cardiovascular Angiography and Interventions
IS - 4
M1 - 100968
ER -