SURGICAL TREATMENT OF OPEN DUCTUS ARTERIOSUS IN PREMATURE INFANTS

Abstract

The open arterial duct (OAD) means the maintenance of the OAD patency in the postnatal period within 48-72 hours after birth. OAD in preterm infants is of particular importance and often determines their survival. The presence of OAD significantly reduces chances of premature babies to recover, as it contributes to the emergence and aggravation of diseases such as necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), renal dysfunction, intraventricular hemorrhage (IVH), cerebral palsy and, often, the death of a newborn. From this point of view, there is appeared the importance of diagnosis and treatment of OAD in premature newborns to improve the prognosis of life in this category of patients. Until today, there is no generally accepted strategy for treating OAD in premature infants. As a result, in various neonatal centers, even within the same country, doctors adhere to different tactics in the treatment of OAD in premature infants. Surgical correction of the hemodynamically significant OAP is indicated for premature infants dependent on artificial ventilation of the lungs, with lack of the effect of the drug therapy or inability to introduce medication. In this scientific review, 3 technologies of surgical treatment of OAD are discussed: open surgery, thoracoscopy, and endovascular treatment. Special attention is paid to postoperative management of patients and prevention of complications.