patent ductus arteriosus

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Original Article

Mean Platelet Volume to Platelet Distribution Width Ratio: The Most Effective Platelet Parameter in the Closer of Ductus Arteriosus

Abstract

Background

The role of platelets and platelet indices in the closure of the ductus arteriosus in premature infants is still controversial. We aimed to determine whether the platelet count and all platelet-related indices are effective on the closer of patent ductus arteriosus (PDA).

Objectives

Demographic characteristics, prematurity morbidities, and platelet indices were compared between groups with and without hemodynamically significant PDA (hsPDA).

Methods

Data of premature infants with a gestational age of <30 weeks were evaluated retrospectively. All platelet-related data were recorded from the complete blood count in the first 24 hours of all patients. The statistical analysis was performed on the obtained data. A p-value of <0.05 was considered statistically significant.

Results

A total of 1151 patients were included in the study, including 426 patients in the hsPDA group and 725 patients in the non-hsPDA group. Platelet parameters mean platelet volume (MPV), MPV/ plateletcrit (PCT), MPV/ platelet distribution width (PDW), platelet mass (PM), red cell distribution width (RDW) values were found to be significantly lower in the hsPDA group compared to the non-hsPDA group (p<0.001, p<0.001, p<0.001, p=0.015, and p<0.001, respectively). MPV/PDW ratio with the highest AUC value (0.748) was found to be the most valuable parameter in estimating the closer of PDA.

Conclusions

The MPV/PDW ratio was found to be the most valuable parameter for the prediction of hsPDA among all platelet indices.

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Research Letter

Percutaneous Patent Ductus Arteriosus Closure in a Conjoined Twin: Case Report

Paulo Correia Calamita et al. Jonathan Guimarães Lombardi Mayra Rosana Palmeira Barreto Orlando Carlos Barbosa … Maurício Lopes Prudente Zacarias Calil Hamu Giulliano Gardenghi

Abstract

Conjoined twin patients with patent ductus arteriosus and hemodynamic repercussions have a worse prognosis. In the present case report, we demonstrate the first successful percutaneous closure of the ductus arteriosus with the Piccolo© device (Abbot Structural Heart, Plymouth, MN, USA) in this type of clinical situation.

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Review Article

Therapeutic Efficacy and Safety of Paracetamol versus Ibuprofen in Patent Ductus Arteriosus in Newborns: A Systematic Review

Halecy Davidson Sousa da Silva et al. Eryvelton de Souza Franco Larissa Caroline de Almeida Sousa Lima Maria Bernadete de Sousa Maia

ABSTRACT

Closure of the ductus arteriosus (DA) using cyclooxygenase (COX) inhibitors is considered the first-line treatment for hemodynamically significant patent ductus arteriosus (PDA). Physiologically, prostaglandins have a recognized role in PDA. Admittedly, the comparative efficacy and safety between ibuprofen and acetaminophen need to be determined for rational choice of drug therapy for closure of the DA in clinical protocols.

This study aims to present the aspects of the efficacy and therapeutic safety of paracetamol versus ibuprofen in the treatment of PDA in premature newborns.

A systematic review of the literature was carried out, following the recommendations of the PRISMA protocol, using the Medline, Pubmed, LILACS, and SciELO databases. Studies from the last 10 years (2013-2023) that analyzed the efficacy and/or safety of acetaminophen compared to ibuprofen in newborns diagnosed with PDA were included.

Eight randomized clinical trials (RCTs) were selected for analysis, resulting in a sample size of 781 newborns with PDA treated with acetaminophen or ibuprofen. The efficacy of acetaminophen for DA closure is comparable to ibuprofen. There is no statistically significant difference in the incidence of related adverse effects between the two drugs in most studies.

There is equivalence in the efficacy and safety of ibuprofen and acetaminophen to promote closure of the DA in premature newborns with hsPDA.

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Case Report

Percutaneous Retrieval of a Vegetation in a Pediatric Patient with Patent Ductus Arteriosus: A New Technique to Avoid Thoracotomy

Miguel Fabian Barrerra-Colín et al. José Luis Colín-Ortiz Carlos Alfonso Corona-Villalobos

Abstract

Infective endocarditis in the pediatric population is a rare condition that may or may not be associated with a congenital heart disease. Current treatment modalities are based on long-term antibiotic therapy and surgical resection as the first option for cases of persistent vegetation. We present a case of successful percutaneous retrieval of a vegetation in a patent ductus arteriosus, that extended to the pulmonary artery trunk in a pediatric patient. This is the first report in the literature on this type of extraction of vegetation in the ductus arteriosus without thoracotomy.

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Artigo Original

Overall experience with percutaneous occlusion of the patent ductus arteriosus

Carlos Augusto Cardoso Pedra et al. Simone Rolim Fenandes Fontes Pedra César Augusto Esteves Sérgio Luís Navarro Braga … Maria Aparecida Paula Silva Tarcísio Luís Valle de Almeida Maria Virgínia Tavares Santana José Eduardo Moraes Rego Sousa Valmir Fernandes Fontes

PURPOSE: To evaluate the overall experience of our institution with percutaneous occlusion of the patent ductus arteriosus. METHODS: Since December/92, 150 patients underwent 178 procedures (85 – Rashkind technique; 87 – Gianturco coils; 6 – Duct Occlud). Median age was 6.5 years (1 to 57). Mean minimum ductal diameter was 3.05±1.24mm (1 to 8). Clinical and echocardiographic evaluations were performed periodically. RESULTS: Adequate implantation was achieved in 143 (95.3%) patients. Prevalence of immediate residual shunting was 52.1%, falling to 15.9% during follow-up. This figure decreased to 5.2% after new additional procedures. Umbrella and coil embolization occurred in 1 and 12 procedures, respectively. Hemolysis and mild stenosis of left pulmonary artery were observed in one patient each. There was no mortality. CONCLUSION: This therapeutic modality is safe and efficacious with good follow-up results.

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Mean Platelet Volume to Platelet Distribution Width Ratio: The Most Effective Platelet Parameter in the Closer of Ductus Arteriosus

Abstract

Background

Objectives

Methods

Results

Conclusions

Percutaneous Patent Ductus Arteriosus Closure in a Conjoined Twin: Case Report

Abstract

Therapeutic Efficacy and Safety of Paracetamol versus Ibuprofen in Patent Ductus Arteriosus in Newborns: A Systematic Review

ABSTRACT

Percutaneous Retrieval of a Vegetation in a Pediatric Patient with Patent Ductus Arteriosus: A New Technique to Avoid Thoracotomy

Abstract

Overall experience with percutaneous occlusion of the patent ductus arteriosus

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