… E se il dotto arterioso pervio persiste nonostante la terapia con ibuprofene?

Patent ductus arteriosus (PDA) with significant left-to-right shunt is a major cause of increased morbidity and mortality in preterm infants. Early closure of ductus arteriosus may be pharmacologically achieved using cyclooxygenase inhibitors, or via surgery. Herein we describe an unusually complicated case of a preterm infant with PDA. The newborn was unsuccessfully treated with ibuprofen. After medical treatment failure, surgery was scheduled and the ductus was closed with no complications. In the discussion we compare the three main management options for preterm neonates with PDA: ibuprofen, indomethacin and surgical treatment.