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COMPARISON OF EFFECTIVITY AND EXPENDITURE BETWEEN TRANS-CATHETER OCCLUSION OF PDA OR SURGICAL CLOSURE OF PDA

Dr Muhammad Usman, Dr Ghulam Murtaza, Dr Abdul Salam

Objectives: This research work carried out to compare the effectivity and expense of the trans-catheter occlusion of PDA (Patent Ductus Arteriosus) with the surgical closure of PDA. Methodology: This retrograde research work carried out in Cardiology Department of General Hospital, Lahore. Total two hundred and fifty pediatric patients who underwent PDA closure either trans-catheter or surgical way with the utilization of the SHSMA occlude present with greater than five kilogram weight from May 2016 to November 2019 were the participants of this research work. SPSS V.22 was in use for the statistical analysis of the collected information. We utilized the T-test for the comparison of the quantitative variables. We used the Chi square test for various qualitative variables. P value of less than 0.050 was significant statistically. Results: There were total 120 patients underwent trans-catheter occlusion of patent ductus arteriosus with utilization of SHSMA Occluder forming PDA Device-Group and there were 130 patients who had to undergo surgical ligation of PDA making Surgical-Group. The prevalence of residual shunting was 1.50% (n: 2) in patients of surgical-group and no patient was present in PDA Device-group in the first thirty days of follow up. The rate of major complications was 3.10% (4) in surgical-group. There was high rate of transfusion of blood in the patients of surgical-group (P value = 0.040). There was less duration of hospital stay in PDA Device-group (P value of less than 0.0010). Total cost of the procedure in Pakistani rupees was 110695 ± 1054 in PDA Device-group and 92414 ± 3512 in the surgical-group (P value of less than 0.0010). The total expense of device closure of PDA was 16.520% greater than the PDA closure of surgical ligation. We found no surgical mortality. Conclusion: The process of trans-catheter closure of patent ductus arteriosus is very effectual and less invasive in comparison with the surgical ligation closure. There is very low complication rate and the procedural expense in not much high in comparison with the surgical ligation of PDA. Key Words: PDA, prevalence, mortality, ligation, expense, device group.