Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Anesthesiology, Nationwide Children's Hospital, Columbus, OH, USA; The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
Clin Perinatol. 2022 Mar;49(1):149-166. doi: 10.1016/j.clp.2021.11.009. Epub 2022 Jan 21.
Percutaneous-based patent ductus arteriosus closure is technically feasible among infants less than 1.5 kg. However, marked heterogeneity in the type and nature of adverse events obscures current safety profile assessments. Although data on the risks of postdevice closure syndrome remain promising, a lack of comparative trials of surgical ductal ligation and inconsistent surveillance across published studies obscure confidence in present estimates of safety and efficacy. To minimize risk and yield the greatest benefits, clinical studies of patent ductus arteriosus treatment should consider incorporating more robust assessments to ensure that infants at greatest risk for adverse ductal consequences are included.
经皮动脉导管未闭封堵术在体重小于 1.5 公斤的婴儿中具有技术可行性。然而,不良事件的类型和性质存在显著差异,这使得目前的安全性评估变得复杂。尽管关于封堵后综合征风险的数据仍很有前景,但由于缺乏与手术结扎导管的对照试验以及发表的研究之间监测不一致,使得目前对安全性和疗效的估计缺乏信心。为了最大限度地降低风险并获得最大效益,动脉导管未闭治疗的临床研究应考虑纳入更有力的评估,以确保将那些存在不良导管后果风险最大的婴儿纳入其中。