Evidence map›Paper›PMID 40670705›Full record

ArticlePediatric surgery international2025

Outcomes of CDH patients receiving PDA ligation: a propensity score matched analysis.

Hamzah Mansoura, Chelsea Drennan, Vikas S Gupta, Matthew T Harting, Neil Patel, Ashley H Ebanks, Shobhan Vachhrajani, Daniel K Robie

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Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Hamzah MansouraDepartment of Surgery, Florida State University School of Medicine, 1115 West Call Street, Tallahassee, FL, 32306, USA.
Chelsea DrennanDayton Children's Hospital, One Children's Plaza, Dayton, OH, 45404, USA.
Vikas S GuptaDepartment of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, 6411 Fannin St, Houston, TX, 77030, USA.
Matthew T HartingDepartment of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, 6411 Fannin St, Houston, TX, 77030, USA.
Neil PatelDepartment of Neonatology, Royal Hospital for Children, 1345 Govan Rd, Glasgow, G51 4TF, UK.
Ashley H EbanksDepartment of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, 6411 Fannin St, Houston, TX, 77030, USA.
Shobhan VachhrajaniDayton Children's Hospital, One Children's Plaza, Dayton, OH, 45404, USA.
Daniel K RobieDayton Children's Hospital, One Children's Plaza, Dayton, OH, 45404, USA. robied@childrensdayton.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeonates with congenital diaphragmatic hernia (CDH) have varying severity of pulmonary hypertension (PH) caused by developmental and structural abnormalities of the pulmonary vasculature and exacerbated by hypoxia induced vasoconstriction. Failure of the ductus arteriosus to close postnatally can intermittently shunt blood either to or away from the lungs. We hypothesize patent ductus arteriosus (PDA) ligation can be performed.

methodsWe queried the Congenital Diaphragmatic Hernia Study Group registry to identify patients from 2007 to 2020 who underwent PDA ligation. We excluded patients with missing prenatal data, postnatal diagnosis > 28 days, CDH never repaired, death < 30 days, and PDA ligated on day of or before CDH repair. Patients were matched 4:1 on propensity scores for PDA ligation. The primary outcome was mortality. The secondary outcome was any use of extracorporeal life support (ECLS).

results3953 cases were identified for analysis (3899 in no PDA ligation (-PDAL) group, 54 in PDA ligation (+ PDAL) group). After 4:1 matching, there were 196 in the -PDAL group and 49 in the + PDAL group. There was no significant difference in mortality (OR 1.1, (0.5-2.4), p = 0.811) or in use of ECLS (OR 1.5 (0.8-2.8), p = 0.218) between the two groups.

conclusionsPDA ligation can be considered as a therapeutic option for CDH patients with persistent ductus arteriosus. It may have a role in highly selected cases that have exhausted other therapeutic options. LEVEL OF EVIDENCE: Level III evidence.

Indexed as

Ductus Arteriosus, PatentHernias, Diaphragmatic, CongenitalExtracorporeal Membrane OxygenationFemaleHumansInfant, NewbornLigationMalePropensity ScoreRegistriesRetrospective StudiesTreatment OutcomeCDH study groupCongenital diaphragmatic herniaPDARegistry

Identifiers

PMID40670705

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