@article {HeuchanF39, author = {Anne Marie Heuchan and Lindsey Hunter and David Young}, title = {Outcomes following the surgical ligation of the patent ductus arteriosus in premature infants in Scotland}, volume = {97}, number = {1}, pages = {F39--F44}, year = {2012}, doi = {10.1136/adc.2010.206052}, publisher = {BMJ Publishing Group}, abstract = {Objective To determine morbidity, mortality and associated risk factors following patent ductus arteriosus (PDA) ligation in premature infants. Methods Retrospective case note audit of premature infants referred to a national paediatric cardiothoracic surgical service (2001{\textendash}2007) with univariate and multivariate analysis of potential risk factors for mortality and morbidity. Results 125 infants were enrolled (median gestational age 26 weeks (IQR 25{\textendash}27 weeks), median birth weight 840 g (IQR 730{\textendash}1035 g)). Referral characteristics were median LA:Ao 1.8 (IQR 1.5{\textendash}2.0), 80\% ventilated, 18.4\% continuous positive airway pressure, 70\% diuretics and 58\% prior treatment with cyclooxygenase inhibitors (COIs). Median age at PDA ligation was 31 days (IQR 25{\textendash}41 days). Postoperative characteristics were median time to extubation 5 days (IQR 3{\textendash}10 days), 36.0\% corticosteroids, 46.8\% domiciliary oxygen and 4.8\% vocal cord palsy. The 30-day and 1-year mortality rates were 4.8\% and 12.8\%, respectively, with neurodisability in 32\% of survivors. All deaths occurred in the ventilated group and were mainly attributable to bronchopulmonary dysplasia (BPD). Gestation and fractional inspired oxygen (FiO2)\>60\% were significantly associated with 30-day mortality. FiO2, ventilation, lack of prior COIs and postoperative corticosteroids were significantly associated with 1-year mortality. Preoperative FiO2\>40\% and lack of prior COIs retained independent significance for death at 1 year. Conclusions PDA ligation is well tolerated, with evidence of early benefit. The incidence of neurodisability or death from BPD at 1 year remains high. Increasing preoperative FiO2 and lack of prior treatment with COIs are associated with increased mortality at 1 year.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/97/1/F39}, eprint = {https://fn.bmj.com/content/97/1/F39.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }