title: Comparison of effectiveness and cost of patent ductus arteriosus device occlusion versus surgical ligation of patent ductus arteriosus.
abstract: OBJECTIVE
  Comparison of effectiveness and cost of transcatheter occlusion of patent ductus arteriosus (PDA) with surgical ligation of PDA.
  
  
  METHODS
  This retrospective comparative study was conducted in the pediatric cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Data of 250 patients who underwent patent ductus arteriosus (PDA) closure either surgical or trans-catheter closure using SHSMA Occluder having weight >5 kg from April 2012 to October 2015 were included in this study. SPSS version 20 was used for data analysis. Quantitative variables were compared using independent sample t-test. Chi-square test and fishers exact was used for qualitative variables. P-value <0.05 was considered statistically significant.
  
  
  RESULTS
  There were one hundred and twenty (120) patients who underwent transcatheter occlusion of PDA using SHSMA occluder (PDA Device Group) and one hundred and thirty (130) patients who underwent surgical ligation of PDA (Surgical Group). Incidence of residual shunting was two (1.5%) in surgical group and 0 (0.0%) in PDA Device group for one month follow up period. There were 4 (3.1%) major complications in surgical group. The rate of blood transfusions were high in surgical group (p-value 0.04). Hospital stay time was significantly less in PDA Device group (P-value <0.001). Total procedural cost was 110695+1054 Pakistani rupees in PDA Device group and 92414+3512 in surgical group (p-value <0.001). The cost of PDA device closure was 16.52% higher than the surgical ligation of PDA. There was no operative mortality.
  
  
  CONCLUSIONS
  The transcatheter closure of PDA is an effective and less invasive method as compared to the surgical ligation. There is a lower rate of complications and the cost is not much high as compared to surgical PDA ligation.
authors.affiliation: Dr. Arif Zulqarnain, MBBS, FCPS Paediatrics. Fellow Paeds Cardiology, Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan.
authors.forename: Arif
authors.initials: A
authors.lastname: Zulqarnain
authors.affiliation: Dr. Muhammad Younas, FCPS Paediatrics, FCPS Paeds Cardiology. Assistant Professor and Head of Paeds Cardiology Department, Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Younas
authors.affiliation: Dr. Tariq Waqar, FCPS Surgery, FRCS. Associate Professor and Head of Paeds Cardiac Surgery Department, Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan.
authors.forename: Tariq
authors.initials: T
authors.lastname: Waqar
authors.affiliation: Dr. Ahsan Beg, MBBS, FCPS Paediatrics, FCPS Paeds Cardiology. Assistant Professor Paeds Cardiology, Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan.
authors.forename: Ahsan
authors.initials: A
authors.lastname: Beg
authors.affiliation: Dr. Touseef Asma, MBBS, FCPS Paediatrics, FCPS Paeds Cardiology. Senior Registrar Paeds Cardiology, Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan.
authors.forename: Touseef
authors.initials: T
authors.lastname: Asma
authors.affiliation: Mr. Mirza Ahmad Raza Baig, B.Sc Hons Cardiac Perfusion Technology. Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan.
authors.forename: Mirza Ahmad Raza
authors.initials: MA
authors.lastname: Baig
keywords: Patent ductus arteriosus; Surgical ligation