Open Access

REVIEW

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

by Rohan Suresh Daniel^1,2, Georgia K. Schmidt^1,2, Hayato Nakanishi^1,2, Karen Smayra^1,2, Mariah N. Mascara^1,2, Dilip K. Vankayalapati^1,2, Reem H. Matar^1,2,3, Christian A. Than^1,2,4, George Shiakos⁵, Ioannis Tzanavaros^2,5,*

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:

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

Received 05 November 2022; Accepted 09 January 2023; Issue published 15 March 2023

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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Keywords

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