Prophylactic surgical ligation of patent ductus arteriosus for prevention of mortality and morbidity in extremely low birth weight infants

There is no evidence to support the use of prophylactic surgical ligation of the patent ductus arteriosus (PDA) in the management of the preterm infants.

The ductus arteriosus is a blood vessel that is open during fetal life and connects blood flow from the vessel that supplies blood to the lungs to the major vessel that supplies blood to the body (the aorta). This blood vessel can stay open after birth leading to a condition called patent ductus arteriosus (PDA). PDA is one of the most common cardiac conditions in babies who are born very early (premature) and can lead to significant complications and death. Prophylactic (very early) closure of the ductus arteriosus (within 72 hours after birth) can be achieved medically or surgically. Llittle is known about the effectiveness and safety of very early surgical closure (ligation). The review found that surgical ligation in preterm infants reduced the risk of severe necrotizing enterocolitis (NEC), a gastrointestinal disease that mostly affects premature infants involving infection and inflammation of the bowel (intestine); however, early surgical ligation did not decrease the risk of death, chronic lung disease and other major complications of preterm infants. In view of the lack of significant benefit and growing data suggesting the potential harm of such treatment modality, current evidence does not support the use of early surgical ligation of PDA in the management of preterm infants.