Abstract:
BACKGROUND:The indications for ductus arteriosus ligation in very-low-birth-weight infants (VLBWIs) with persistent ductus arteriosus (PDA) are unclear. Increased left ventricular end-diastolic dimension (LVDd) is commonly found in patients with PDA. Here, the enlargement of LVDd in term and preterm neonates without congenital heart disease was estimated by two-dimensional echocardiography. METHODS:The value of the measured LVDd was divided by the normal LVDd as an index (LVDd ratio) to compare 30 patients who underwent PDA ligation with 30 patients treated with indomethacin and 30 patients who did not undergo radical therapy. RESULTS:An LVDd ratio between 122% and 197% (mean, 142%) was considered to be an indication for the ligation procedure. The proportion of patients exceeding 130% in the LVDd ratio was 87% (26/30) in those patients who underwent ligation. Catecholamines and/or vasodilators were required in 83% patients for the treatment of low ejection fraction or hypertension after operations, suggesting that patients had been in preload and/or afterload remodeling failure during the operation. The percentage of patients with less than 115% in the LVDd ratio was 90% in the non-radical-therapy patients. The LVDd ratios of 130% and 115% were regarded as cut-off values for surgical ligation and indomethacin treatment. CONCLUSION:The LVDd ratio is a useful measure to determine the treatment of VLBWIs with PDA.
journal_name
Pediatr Neonatoljournal_title
Pediatrics and neonatologyauthors
Nagasawa H,Terazawa D,Kohno Y,Yamamoto Y,Kondo M,Sugawara M,Koyama T,Miura Rdoi
10.1016/j.pedneo.2013.10.009subject
Has Abstractpub_date
2014-08-01 00:00:00pages
250-5issue
4eissn
1875-9572issn
2212-1692pii
S1875-9572(13)00224-6journal_volume
55pub_type
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