Immediate Outcomes of Transcatheter Closure versus Surgical Ligation of Patent Ductus Arteriosus in Children at the Cardiac Center of Ethiopia (2012-2022): A Comparative Cross-Sectional Study

TL;DR

This study compares the immediate outcomes of two treatments for patent ductus arteriosus in children in Ethiopia, finding that transcatheter closure has fewer complications and shorter recovery times than surgical ligation.

Contribution

The study provides a comparative analysis of transcatheter closure and surgical ligation for PDA in an Ethiopian cardiac center, focusing on immediate outcomes.

Findings

Transcatheter closure had significantly fewer overall complications compared to surgical ligation (35.4% vs 71.9%).

Surgical ligation resulted in longer mechanical ventilation, ICU, and hospital stays.

Transcatheter closure is recommended for selected patients due to its lower complication rate and faster recovery.

Abstract

Transcatheter closure and surgical ligation of patent ductus arteriosus (PDA) are management options for PDA that have not spontaneously closed. However, studies reported the presence of complications and residual shunts in both Transcatheter closure and surgical ligation of PDA by themselves. In this study, the immediate outcomes of transcatheter closure of PDA versus surgical ligation of PDA were compared.

Comparative cross-sectional study conducted on children under 18 years of age who underwent transcatheter closure and surgical ligation of PDA at a cardiac center in Ethiopia from January 1, 2012, to January 1, 2022, by retrospectively reviewing the records from October 1, 2023, to November 1, 2023. 664 patients who underwent PDA closure, (n = 316) in the transcatheter closure group and (n = 348) patients in the surgical ligation group were included in this study.

The surgical ligation group patients were younger, and more proportion of patients had severe pulmonary hypertension. Overall complications were significantly higher with surgical ligation compared with transcatheter closure ((112 (35.4% vs 286 (71.9%)), p-value = 0.001)). Total mechanical ventilation time, intensive care unit(ICU) stay, and hospital stay were higher in the surgical ligation group with a p-value of 0.001 each.

Transcatheter closure of PDA has lower overall complications and shorter mechanical ventilation time, lower ICU stay, and lower hospital stay. Given the lower number of overall complications, transcatheter closure of PDA has to be considered for selected patients.

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