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Patent Ductus Arteriosus in Premature Infants: Incidence, Relation to Pulmonary Disease and Management

Abstract:

Patent ductus arteriosus (PDA) developed in 17 of 111 premature infants (birth weight 1750 g or less) born during a four-year period (15.3 per cent incidence). During that time we treated 29 such infants, 17 born at our own institution and 12 similar infants transferred from other hospitals. Sixteen of the 29 had cardiac catheterization, 10 had operative closure of the PDA, and 24 survived. When the PDA became evident, 23 infants had no pulmonary disease, were recovering from the idiopathic respiratory-distress syndrome (IRDS) or had chronic lung disease; all survived. In six infants with severe IRDS, onset of PDA was associated with a worsening of the pulmonary status; only one survived. We recommend cardiac catheterization and operative closure of the PDA in neonates when heart failure cannot be controlled medically. The prognosis is good in infants in whom onset of PDA is not associated with progressively worsening IRDS.IN 1959 Burnard reported that the incidence of delayed closure of the ductus arteriosus was higher in premature than in term infants.1 Subsequent investigators have described persistent patent ductus arteriosus (PDA) in premature infants with and without the idiopathic respiratory-distress syndrome (IRDS).234567 Our experience consists of 29 premature infants with PDA treated during the four years ending December 31, 1970. Clinical Material During the four-year period, 111 infants weighing 1750 g or less were born at the University of California, San Francisco. In 17 (15.3 per cent) who did not have other congenital heart disease or a history of maternal. © 1972, Massachusetts Medical Society. All rights reserved.