title: Pros and cons of patent ductus arteriosus ligation: hemodynamic changes and other morbidities after patent ductus arteriosus ligation.
abstract: Although surgical ligation of a persistent patent ductus arteriosus resolves the adverse hemodynamic consequences of the systemic-to-pulmonary shunt and may confer some long-term benefits, it is also associated with both immediate and long-term negative effects. The population that benefits from or is harmed by the procedure is not clearly defined. Although indiscriminate ligation of the patent ductus arteriosus in all patients is not supported by the available information, the recent suggestion declaring the ductus harmless is not supported either. As we await the results of appropriately designed randomized control studies to define the indications for ligation, we must use clinical and echocardiographic indicators of a hemodynamically significant ductus arteriosus and thoughtful assessment of each individual patient to help guide us in addressing this complex problem.
authors.affiliation: Division of Neonatology and Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles and the LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA. snoori@chla.usc.edu
authors.forename: Shahab
authors.initials: S
authors.lastname: Noori
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D004374:Ductus Arteriosus, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D020345:Enterocolitis, Necrotizing / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008297:Male; D018579:Patient Selection; D011247:Pregnancy; D014463:Ultrasonography; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology