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Surgery reduces reinterventions in patent ductus arteriosus

When compared with catheter-based therapy, surgery was linked with lower reintervention rates in nonpremature pediatric patent ductus arteriosus, according to study results.

Jennifer Y. Lam, MD, of the University of Calgary, and colleagues conducted a systematic search of Medline, Embase, PubMed and Cochrane databases of randomized controlled trials from 1950 to February 2014 to compare the results of the two treatment options. The researchers analyzed eight studies (n = 1,107) that met inclusion criteria and observed factors such as repeat intervention, lengths of hospital stay and lengths of procedure.

Decreased odds of reintervention were linked with surgery (n = 640) when compared with catheter-based treatment (n = 467) of patent ductus arteriosus (PDA) (OR = 0.12; 95% CI, 0.03-0.42). There was a minimal, but insignificant, increase in the risk for complications with surgery (OR = 2.01; 95% CI, 0.68-5.91).

Surgery also resulted in a longer length of stay for patients when compared with catheter-based therapy.

The researchers acknowledged that their meta-analysis included more than 3 decades of data, and it may not appropriately reflect current procedures.

“With the evolution of surgical and catheter-based techniques, further large-scale, randomized studies need to be done comparing VATS (video-assisted thoracoscopic surgery) to catheter-based therapy using the Amplatzer Occluder [AGA Medical] and other new devices,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.