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Ligation of patent ductus arteriosus through anterior thoracotomy in preterm infants: a 10-year experience

Part of: Surgery

Published online by Cambridge University Press:  28 January 2021

Arif Selcuk Open the ORCID record for Arif Selcuk [Opens in a new window] ,
Murat Cicek ,
Okan Yurdakok ,
Yigit Kilic ,
Filiz İzgi Coskun ,
Hasan Erdem ,
Turkay Saritas ,
Emine Hekim Yilmaz ,
Oktay Korun  and
H. Firat Altin Open the ORCID record for H. Firat Altin [Opens in a new window]
...Show all authors
Arif Selcuk*
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Murat Cicek
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Okan Yurdakok
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Yigit Kilic
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Filiz İzgi Coskun
Affiliation:
Department of Anesthesiology and Reanimation, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Hasan Erdem
Affiliation:
Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Center, Istanbul, Turkey
Turkay Saritas
Affiliation:
Department of Pediatric Cardiology, Istanbul Medipol University Medicine Faculty, Istanbul, Turkey
Emine Hekim Yilmaz
Affiliation:
Department of Pediatric Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Oktay Korun
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
H. Firat Altin
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Ahmet Sasmazel
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Numan A. Aydemir
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
*
Author for correspondence: Dr A. Selcuk, MD, Department of Pediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Uskudar, Istanbul, 34668, Turkey. Tel: +90-216-542-4444; Fax: +90-216-418-9649. E-mail: kdcaselcuk@gmail.com
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Abstract

Objective:

The aim of this study is to report on the short-term and mid-term outcomes of preterm infants who underwent patent ductus arteriosus ligation through anterior mini-thoracotomy.

Methods:

Data for 103 preterm infants who underwent patent ductus arteriosus clipping through an anterior mini-thoracotomy at the 2nd intercostal space between 2009 and 2019 were retrospectively reviewed. The patients were divided into two groups according to their weight at the time of surgery. The complications, morbidity, and mortality rates of each group were compared at postoperative day 30 and at the end of 1 year after surgery.

Results:

During the operation, the median weight of the patients was 900 g (IQR 800–1125 g), the median age was 21 days (IQR 14.5–29 days). The lowest body weight was 460 g. In three patients (3%), there was intraoperative bleeding from the patent ductus arteriosus that required transition to median sternotomy. In one patient (1%) a residual patent ductus arteriosus that required reoperation was observed. Twelve patients (12%) died in the first 30 days postoperatively. Six patients (6%) died between the postoperative day 30 and 1 year. There was no statistically significant difference in the rates of mortality, morbidity, and complication between the groups.

Conclusions:

Based on our observations of over a hundred preterm infants with patent ductus arteriosus over a decade, ligation through anterior mini-thoracotomy is the main surgical procedure of choice for this patient group in our clinic. Our findings demonstrate the safety of this approach and we believe that it can be successfully replicated in other institutions.

Keywords

congenital heart diseaseminimally invasive surgeryinfant
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 6 , June 2021 , pp. 985 - 991
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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