Bedside surgical ligation of patent ductus arteriosus in very low birth
weight premature infants: limited upper ministernotomy as an alternative
approach
Abstract
Background: Patent ductus arteriosus is an important cause of morbidity
and mortality especially in very low birth weight infants.The aim of the
present study was to evaluate outcomes of bedside surgical ligation of
patent ductus arteriosus via limited upper ministernotomy as an
alternative approach to thoracotomy. Material and Method: A total of 23
low birth weight premature infants who underwent bedside ligation of PDA
in the neonatal intensive care unit January 2017 to April 2020, were
enrolled. The patients were divided into two groups: those with
thoracotomy(n=13) and those with limited upper
ministernotomy(n=10).These patients were evaluated retrospectively in
terms of clinical and preoperative,intraoperative,postoperative
parameters between the groups. Results: Mean birth weight was 1059±275
grams in the thoracotomy group and 1035±285 grams in the ministernotomy
group. There was no statistically significant difference in the age at
surgery,weight at surgery,preoperative MV support,inotropic score onset
of surgery and total procedure time between the groups.There was a
statistically significant difference in the hospital length of
stay,postoperative MV time and complications in the intensive care unit
in favor of the ministernotomy group(p=0.04,p=0.03,p=0.034
respectively).The study showed no statistically significant difference
in the mortality rate between the two groups (2 patients in the
thoracotomy group and 1 patient in the ministernotomy group).
Conclusion:The limited upper ministernotomy is anatomically and
technically feasible alternative to classical left posterolateral
thoracotomy for bedside surgical PDA ligation.