Ligation of patent ductus arteriosus through left anterior
mini-thoracotomy in preterm infants
Abstract
Objective Patent ductus arteriosus (PDA) 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-center short-term results
of preterm patients who underwent patent ductus arteriosus ligation
through left anterior mini-thoracotomy . Methods Data of 27
preterm infants operated by the same surgeon who underwent PDA closure
with left anterior minithoracotomy technique between November 2020 and
January 2022 at a single instution 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 %). There was no
internal thoracic artery injury or no need for conversion to thoracotomy
or sternotomy. there were 6 (22%) deaths in the postoperative first 30
days and 4 (14,8%) deaths between the postoperative first month and
first year. The cause of the deaths were sepsis, NEC, hydrops fetalis,
hepatoblastoma and intracranial bleeding. Left diaphragmatic elevation
developed in 1 patient, and plication was performed. There was no
statistically significant difference in the rates of morbidity, and
complication between the groups. Conclusions PDA closure with
the left anterior mini-thoracotomy method is advantageous in terms of
reducing damage to the already congested lung, shortening the
hypothermia time of the baby by shortening the procedure time, and has
good cosmetic results, especially in very low birth weight preterm
babies.