Comparison of results, complications and cost effectiveness of patent ductus arteriosus (PDA) closure in nonsurgical and surgical methods

There are several methods for PDA closure. This study compared results, complications and cost effectiveness of surgical and nonsurgical PDA closure with coil. Patients who admitted in Shahid Madani Hospital in 2005 surgical and nonsurgical closure of PDA were included in this study. Data were obtained from patients units. All cases followed up for six months. Data were analyzed thorough SPSS. From 21 patients of nonsurgical method in two cases (9.5%), coil embolizations were occurred to pulmonary artery, that they were removed in cath lab and then refered to a surgery unit. One case (4.5%) has residual shunt at PDA, that who was waiting for second coil. In six month follow-up, PDA completely was closed in 18 (86%) patients and no complications were seen.In surgical method there were 42 patients. In six month follow-up, there were residual shunt in 2 (4.7%) cases and chylothorax in 1 (2.3%) patient, transient left diaphragmatic paresis in 2 (4.7%) and transient vocal cord paresis in 2 (4.7%) cases were seen.Mean at hospitalization and ICU, laboratory tests and radiographic examinations in nonsurgical method were significantly less than surgical method (P< 0.0005). There was no significant difference in drug cost between two methods (P= 0.793). Mean cost of instruments and total hospital cost of the patients in nonsurgical method were significantly more than surgical method for high cost of coil (P< 0.0005), but men payment of patients to the hospital in two groups did not have any significant difference (P= 0.056). In general, PDA closure through nonsurgical method had better and effective results and complications. However, it is more expensive.