Analysis of two cases of patent ductus arteriosus ligation in preterm identical twins and literature review

作     者：Xiang Cao Xiao-Ding Chen Ling Yang Ren-Wei Chen Yan Li Ze-Lai Mo Wei Xiang Xiang Cao;Xiao-Ding Chen;Ling Yang;Ren-Wei Chen;Yan Li;Ze-Lai Mo;Wei Xiang

作者机构：Neonatology DepartmentHainan Women and Children’s Medical CenterChildren’s Hospital of Hainan Medical UniversityHaikouHainan 570206China Cardio-Thoracic Surgery DepartmentHainan Women and Children’s Medical CenterChildren’s Hospital of Hainan Medical UniversityHaikouHainan 570206China Anesthesiology DepartmentHainan Women and Children’s Medical CenterChildren’s Hospital of Hainan Medical UniversityHaikouHainan 570206China Ultrasound Imaging DepartmentHainan Women and Children’s Medical CenterChildren’s Hospital of Hainan Medical UniversityHaikouHainan 570206China Key Laboratory of Tropical Translational MedicineMinistry of EducationHainan Medical UniversityHaikouHainan 571199China 

出 版 物：《Journal of Hainan Medical University》 (海南医学院学报（英文版）)

年 卷 期：2020年第26卷第17期

页      面：57-60页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Hainan Major Science and Technology Fund(NO.ZDKJ2019010) 

主　　题：Identical twins Preterm infant Patent ductus arteriosus ligation 

摘      要：Objective:To investigate the timing and effect of surgical ligation in the treatment of patent ductus arteriosus(PDA)in preterm identical ***:Retrospective analysis was made on the treatment of 2 cases of preterm twins with hemodynamic significant PDA(hsPDA)with corresponding clinical manifestation in our neonatology department,and literatures of PDA ligation for preterm twins were ***:These 2 cases were naturally conceived monochorionic diamniotic twins,with gestational age 30+2 weeks,birth weight was 1510g and 780g for larger twin and smaller twin,with birth weight discordance 48.3%.They both developed hsPDA with corresponding clinical manifestation,series Echocardiography showed evidence of left to right shunting and cardiac insufficiency which were left atrial and ventricular enlargement,large PDA(2.8~3.5mm),failed two courses of ibuprofen,N-terminal pro-brain natriuretic peptide level increased significantly,finally received surgical ligation with significant clinical improvement and no related complications.12 cases were found from literature search,including our 2 cases,of these,2 died,9 were cured and 1 improved *** 6 cases whose detailed information were available,4 infants were identical twins,2 ***:Preterm identical twins have the same genetic basis,the possibility of PDA ligation for both the larger twin and smaller twin should be alerted if the gestaional age is small and birth weight discordance is above 30%.If preterm twins have hsPDA who may fail ibuprofen treatment,surgical ligation should be considered early,and it is safe and effective.