{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:30:25Z","timestamp":1775817025841,"version":"3.50.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The goal was to evaluate neonatal outcomes based on treatment strategies and time points for haemodynamically significant patent ductus arteriosus (hsPDA) in very-low-birth-weight preterm infants, with a particular focus on surgical closure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This retrospective study included very-low-birth-weight infants born between 2014 and 2021 who received active treatment for hsPDA. Neonatal outcomes were compared between (i) primary surgical closure versus primary ibuprofen; (ii) early (&amp;lt;14th post-natal day) versus late primary surgical closure (\u226514th post-natal day); and (iii) primary versus secondary surgical closure after ibuprofen failure. Further analysis using 1:1 propensity score matching was performed. Logistic regression was conducted to analyse the risk factors for post-ligation cardiac syndrome (PLCS) and\/or acute kidney injury (AKI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 145 infants with hsPDA underwent active treatment for closure. The in-hospital death rate and the incidence of severe bronchopulmonary dysplasia (BPD) were similar between the primary surgical closure group and the primary ibuprofen group in a 1:1 matched analysis. Severe BPD was significantly higher in the late surgical closure group than in the early primary surgical closure group with 1:1 propensity score matching (72.7% vs 40.9%, P=0.033). The secondary surgical closure group showed the mildest clinical condition; however, the probability of PLCS\/AKI was highest (38.6%) compared to the early (15.2%) or the late primary surgical group (28.1%, P&amp;lt;0.001), especially in extremely premature infants (gestational age &amp;lt; 28 weeks).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Surgical patent ductus arteriosus closure is not inferior to pharmacologic treatment. Considering the harmful effect of a prolonged patent ductus arteriosus shunt exposure, a timely decision and timely efforts should be made to minimize the risk of severe BPD and PLCS\/AKI after surgical closure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae175","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T01:24:49Z","timestamp":1715304289000},"source":"Crossref","is-referenced-by-count":4,"title":["Patent ductus arteriosus management in very-low-birth-weight prematurity: a place for an early operation?"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1911-2187","authenticated-orcid":false,"given":"Won Young","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8589-3159","authenticated-orcid":false,"given":"Sook Kyung","family":"Yum","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9846-9602","authenticated-orcid":false,"given":"Yu-Mi","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3753-0481","authenticated-orcid":false,"given":"Sol","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6839-0303","authenticated-orcid":false,"given":"Ju Ae","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7772-7035","authenticated-orcid":false,"given":"Cheul","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"key":"2024051800061944100_ezae175-B1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.2174\/157339631202160506002215","article-title":"Pathophysiology of patent ductus arteriosus in the preterm infant","volume":"12","author":"Vettukattil","year":"2016","journal-title":"Curr Pediatr Rev"},{"key":"2024051800061944100_ezae175-B2","doi-asserted-by":"crossref","first-page":"605879","DOI":"10.3389\/fped.2020.605879","article-title":"Related factors of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis","volume":"8","author":"Liu","year":"2020","journal-title":"Front Pediatr"},{"issue":"4","key":"2024051800061944100_ezae175-B3","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-2390","article-title":"Trends in patent auctus arteriosus diagnosis and management for very low birth weight infants","volume":"139","author":"Ngo","year":"2017","journal-title":"Pediatrics"},{"key":"2024051800061944100_ezae175-B4","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1001\/jamapediatrics.2020.1447","article-title":"Effect of nonintervention vs oral ibuprofen in patent ductus arteriosus in preterm infants: a randomized clinical trial","volume":"174","author":"Sung","year":"2020","journal-title":"JAMA Pediatr"},{"key":"2024051800061944100_ezae175-B5","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s12887-018-1215-7","article-title":"Early treatment versus expectative management of patent ductus arteriosus in preterm infants: a multicentre, randomised, non-inferiority trial in Europe (BeNeDuctus trial)","volume":"18","author":"Hundscheid","year":"2018","journal-title":"BMC Pediatr"},{"issue":"9","key":"2024051800061944100_ezae175-B6","article-title":"Pulmonary hypertension with prolonged patency of the ductus arteriosus in preterm 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The role of patent ductus arteriosus ligation in bronchopulmonary dysplasia: reexamining a randomized controlled trial","volume":"154","author":"Clyman","year":"2009","journal-title":"J Pediatr"},{"key":"2024051800061944100_ezae175-B16","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1001\/jamapediatrics.2016.5143","article-title":"Association of patent ductus arteriosus ligation with death or neurodevelopmental impairment among extremely preterm infants","volume":"171","author":"Weisz","year":"2017","journal-title":"JAMA Pediatr"},{"key":"2024051800061944100_ezae175-B17","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/s13019-020-01191-2","article-title":"Surgical ligation of patent ductus arteriosus in preterm neonates weighing less than 1500g: a 9-year single center experience","volume":"15","author":"Lee","year":"2020","journal-title":"J Cardiothorac Surg"},{"key":"2024051800061944100_ezae175-B18","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1038\/s41372-020-00772-2","article-title":"Hemodynamic and clinical consequences of early versus delayed closure of patent ductus arteriosus in extremely low birth weight infants","volume":"41","author":"Philip","year":"2021","journal-title":"J Perinatol"},{"key":"2024051800061944100_ezae175-B19","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1038\/s41372-019-0496-5","article-title":"Duration of significant patent ductus arteriosus and bronchopulmonary dysplasia in extremely preterm infants","volume":"39","author":"Mirza","year":"2019","journal-title":"J Perinatol"},{"key":"2024051800061944100_ezae175-B20","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.1007\/s00431-022-04549-x","article-title":"Impact of patent ductus arteriosus shunt size and duration on risk of death or severe respiratory morbidity in preterm infants born in 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