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PDA and pulmonary hypertension: should the duct be ligated?
  1. V A McCulloch,
  2. R M Tulloh
  1. Department of Congenital Heart Disease, Bristol Royal Hospital for Children, Bristol, UK
  1. Correspondence to Robert Tulloh, Department of Congenital Heart Disease, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK; Robert.Tulloh{at}UHBristol.nhs.uk

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Patency of the arterial duct (PDA) in preterm infants is associated with myocardial dysfunction, risk of chronic lung disease (CLD), pulmonary haemorrhage,1 intraventricular haemorrhage (IVH), necrotising enterocolitis (NEC), renal insufficiency and retinopathy of prematurity (ROP),2 and non-steroidal therapy has significant risks.3 Surgical ligation is considered in those with contraindications or who fail to respond to medical treatment. Some do well and are rapidly extubated, but mortality after ligation is 20% with an incidence of CLD of 77%, IVH 33%, NEC 26% and ROP 28%.2 4

One hundred and seventy-three consecutive …

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