title: Bedside surgery to treat patent ductus arteriosus in low-birth-weight premature infants.
abstract: BACKGROUND
  Patent ductus arteriosus (PDA) is commonly seen in premature infants with low birth weights (LBW). It is a condition that has high mortality and morbidity rates. Early closure of the ductus arteriosus may require surgery or medical treatment. However, the decision of first medical approach for symptomatic PDA closure is still debated. In this study, we compared the surgical and medical treatments for the closure of PDA in premature LBW infants.
  
  
  METHODS
  This study included 27 premature infants whose birth weights were lower than 1500 g, who were born in the period between 2011 and 2013 and had symptomatic PDA. Patients were separated into two groups: groups A and B. Group A included patients whose PDAs were closed with medical treatment (n = 16), and group B included patients who had undergone surgical operations for PDA closure (n = 11).
  
  
  RESULTS
  There were no statistically significant differences between groups A and B when the groups were compared in terms of birth weight, gestational age, respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), sepsis, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and pneumothorax. Although the mortality rate was determined to be lower in group B (2 out of 11, 18.1%) than in group A (7 out of 16, 43.7%), no statistically significant difference was found between the two groups. A statistically significant increase was determined in the incidence of kidney function loss in patient group that received Ibuprofen, a medical treatment, in comparison to the patients who had surgery.
  
  
  CONCLUSIONS
  In conclusion, surgery is a safe method to repair PDA in premature LBW infants. Although there is no remarkable difference between surgery and medical treatment, we suggest that a surgical approach may be used as a first choice to repair PDA considering the lower rate of mortality and morbidity and higher rate of closure compared to medical treatment.
authors.affiliation: Department of Cardiovascular Surgery, Izmir University, Medical Park Hospital, Izmir, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Albayrak
authors.affiliation: Department of Cardiovascular Surgery, Izmir University, Medical Park Hospital, Izmir, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Aykut
authors.affiliation: Department of Cardiovascular Surgery, Dr. Behcet Uz Children Hospital, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karacelik
authors.affiliation: Department of Pediatry, Izmir University, Medical Park Hospital, Izmir, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Soylar
authors.affiliation: Department of Cardiovascular Surgery, Tepecik Research Hospital, Izmir, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Karaarslan
authors.affiliation: Department of Cardiovascular Surgery, Tepecik Research Hospital, Izmir, Turkey.
authors.forename: Burçin
authors.initials: B
authors.lastname: Abud
authors.affiliation: Department of Cardiovascular Surgery, Izmir University, Medical Park Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Guzeloglu
authors.affiliation: Department of Cardiovascular Surgery, Izmir University, Medical Park Hospital, Izmir, Turkey.
authors.forename: Eyup
authors.initials: E
authors.lastname: Hazan
keywords: low birth weight; patent ductus arteriosus; surgery