{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:58:41Z","timestamp":1790668721755,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,1,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Pharmacologic therapy for patent ductus arteriosus closure is not consistently successful. Surgical ligation (SL) or transcatheter closure (TC) may be needed. Large multicenter analyses comparing outcomes and resource use between SL and TC are lacking. We hypothesized that patients undergoing TC have improved outcomes compared with SL, including mortality, hospital and intensive care unit length of stay, and mechanical ventilation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using the 2016 to 2020 Pediatric Health Information System database, characteristics, outcomes, and charges of patients aged &lt;1\u00a0year who underwent TC or SL were analyzed. A total of 678 inpatients undergoing TC (n=503) or SL (n=175) were identified. Surgical patients were younger (0.1 versus 0.53\u00a0years;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and more premature (60% versus 20.3%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Surgical patients had higher mortality (1.7% versus 0%;\n              <jats:italic>P<\/jats:italic>\n              =0.02). Using inverse probability of treatment weighting by the propensity score, multivariable\u2010adjusted analyses demonstrated favorable outcomes in TC: intensive care unit admission rates (adjusted odds ratio [OR], 0.2; 95% CI, 0.11\u20130.32;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); mechanical ventilation rates (adjusted OR, 0.3; 95% CI, 0.19\u20130.56;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); and shorter hospital (adjusted coefficient, 2\u00a0days shorter; 95% CI, 1.3\u20132.7;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and postoperative (adjusted coefficient, 1.2\u00a0days shorter; 95% CI, 0.1\u20132.3;\n              <jats:italic>P<\/jats:italic>\n              =0.039) stays. Overall charges and readmission rates were similar. Among premature neonates and infants, hospital (adjusted difference in medians, 4\u00a0days; 95% CI, 1.7\u20136.3 days;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and postoperative stays (adjusted difference in medians, 3\u00a0days; 95% CI, 1.1\u20134.9 days;\n              <jats:italic>P<\/jats:italic>\n              =0.002) were longer for SL.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">TC is associated with lower mortality and reduced length of stay compared with SL. Rates of TC continue to increase compared with SL.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.022776","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T11:35:42Z","timestamp":1640950542000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":41,"title":["Trend and Outcomes for Surgical Versus Transcatheter Patent Ductus Arteriosus Closure in Neonates and Infants at US Children\u2019s Hospitals"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0106-858X","authenticated-orcid":false,"given":"Michael T.","family":"Kuntz","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Critical Care and Pain Medicine Boston Children\u2019s HospitalHarvard Medical School Boston MA"},{"name":"Division of Pediatric Cardiac Anesthesiology Department of Anesthesiology Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7588-7596","authenticated-orcid":false,"given":"Steven J.","family":"Staffa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care and Pain Medicine Boston Children\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Boston Children\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Faraoni","sequence":"additional","affiliation":[{"name":"Arthur S. Keats Division of Pediatric Cardiovascular Anesthesia Department of Anesthesiology, Perioperative and Pain Medicine Texas Children's HospitalBaylor College of Medicine Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Newborn Medicine Department of Pediatrics Boston Children\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"DiNardo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care and Pain Medicine Boston Children\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-3658","authenticated-orcid":false,"given":"Nicola","family":"Maschietto","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2321-3987","authenticated-orcid":false,"given":"Viviane G.","family":"Nasr","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Critical Care and Pain Medicine Boston Children\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3431"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12701"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12712"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.592063"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.06.046"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2418"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12729"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-303816"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-019-0342-7"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1209"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.04.069"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.10.020"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1698459"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.05.070"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12700"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28973"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.08.009"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1768-5"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27808"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.03.040"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-011-0130-6"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.09.007"},{"key":"e_1_3_1_24_2","unstructured":"The Pediatric Health Information System . https:\/\/www.childrenshospitals.org\/phis. 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