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Ligation of patent ductus arteriosus through left anterior mini-thoracotomy in preterm infants

Published online by Cambridge University Press:  25 May 2022

Yiğit Kılıç Open the ORCID record for Yiğit Kılıç [Opens in a new window] ,
Ahmet Kuddusi Irdem ,
Onur Doyurgan Open the ORCID record for Onur Doyurgan [Opens in a new window] ,
Gül Özlem ,
Hasan Balik ,
Esra Aktiz Bıcak ,
Fikret Salik  and
Bedri Aldudak
Yiğit Kılıç*
Affiliation:
Department of Pediatric Cardiac Surgery, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Ahmet Kuddusi Irdem
Affiliation:
Department of Pediatric Cardiac Surgery, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Onur Doyurgan
Affiliation:
Department of Pediatric Cardiac Surgery, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Gül Özlem
Affiliation:
Department of Pediatric Cardiology, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Hasan Balik
Affiliation:
Department of Pediatric Cardiology, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Esra Aktiz Bıcak
Affiliation:
Department of Anesthesiology and Reanimation, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Fikret Salik
Affiliation:
Department of Anesthesiology and Reanimation, Dicle University Medical Faculty, Diyarbakir, Turkey
Bedri Aldudak
Affiliation:
Department of Pediatric Cardiology, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
*
Author for correspondence: Yigit Kilic, Department of Pediatric Cardiac Surgery, Dr. Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey. E-mail: dr-yigit@yandex.com
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Abstract

Objective:

Patent ductus arteriosus is an important cause of morbidity and mortality, especially in very low birth weight infants. The aim of the study is to report our single-centre short-term results of preterm patients who underwent ligation through left anterior mini-thoracotomy .

Methods:

Data of 27 preterm infants operated by the same surgeon who underwent Patent ductus arteriosus (PDA) closure with left anterior mini-thoracotomy technique between November 2020 and January 2022 at a single institution were reviewed. The patients were divided into two groups according to their weight at the time of surgery. Data on early postoperative outcomes and survival rates after discharge were collected.

Results:

Twenty-seven patients with a mean (±SD) gestational age of 25.8 (±2.0) weeks and a mean birth weight of 1027 (±423) g were operated using left anterior mini-thoracotomy technique. The lowest body weight was 480 g. Complications such as bleeding, abnormal healing of incision, or pneumothorax were not seen. There were 8 mortalities after the operation (29,6 %). The causes of the deaths were sepsis, necrotising enterocolitis, hydrops fetalis, hepatoblastoma, and intracranial bleeding. There was no statistically significant difference in the rates of complication between the groups.

Conclusions:

Left anterior mini-thoracotomy technique can be performed as the first choice when transcatheter intervention cannot be applied in preterm infants. It provides easy access to the PDA, a good exposure, minimal contact with the lungs, good cosmetic results in early and mid-term and shortens the operation time, especially in very low birth weight preterm babies. However, early ligation may be helpful to minimise the complications related to PDA.

Keywords

Patent ductus arteriosusPrematureMinimally invasive surgery
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 1 , January 2023 , pp. 113 - 118
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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