Ligation of Patent Ductus Arteriosus via Anterior Thoracotomy in Preterm
Infants: 10-Year Experience
Abstract
BACKGROUND The aim of this study is to describe the short-term and
mid-term outcomes of the preterm infants who underwent patent ductus
arteriosus (PDA) ligation in by anterior mini-thoracotomy. METHODS Data
of 103 preterm infants who underwent PDA ligation by anterior
mini-thoracotomy between 2009 and 2019 were retrospectively reviewed.
PDA was clipped through an anterior mini-thoracotomy at the 2nd
intercostal space. Outcomes were defined according to complications,
morbidity and mortality rates within the postoperative 30 days and one
year. RESULTS The median weight of the patients during the operation was
900 (IQR800–1125 g) grams and the lowest body weight was 460 grams. The
median age at the operation was 21 (IQR14,5–29 days) days. In three
patients (3%) there was intraoperative bleeding from the PDA that
required transition to median sternotomy. In one patient (1%) residual
PDA was seen and this patient was reoperated on the 4th postoperative
day. One patient (1%) underwent surgical revision for chylothorax and
chylomediastinum causing late cardiac tamponade on the 26th
postoperative day. Twelve patients (12%) died in the first 30 days
postoperatively. Six patients (6%) died between the thirtieth day and a
year. CONCLUSIONS After a decade and over a hundred patients with PDA
ligation through anterior mini-thoracotomy in preterm infants is still
the main procedure of choice in this patient group in our clinic. Our
outcomes demonstrate the safety of this approach and we believe that it
can be reproducible.