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Closure of a patent ductus arteriosus in pre-term neonates using a left anterior mini-thoracotomy
Ali Riza Karaci1, Ahmet Sasmazel, Saritas Turkay
1Cardiovascular Surgery Clinic, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Haydarpaşa, İstanbul, Turkey.
Objectives:
We present a surgical technique for closure of a patent ductus arteriosus (PDA) in pre-term neonates. Left anterior mini-thoracotomy is a surgical procedure that consists of an anterior mini-thoracotomy (~1.5 cm) below the clavicle, clipping the PDA, and closing the thorax without a tube thoracotomy.
Methods:
Using this method between 2009 and 2012, we performed PDA closure in 32 pre-term neonates. Logistic regression analysis of potential risk factors for mortality was determined.
Results:
The mean weight of the patients at the operation was 822.81 ± 24.59. The mean age at the operation was 28.97 ± 2.20 days. No surgery-related mortalities occurred. Four short-term mortalities occurred after the operation (12.5%) before the patients could be discharged. Three were due to sepsis, and one was due to necrotizing enterocolitis. According to the linear regression analysis, no other variables were found to be statistically significant for predicting mortality. A negative linear correlation was found between the weight of the patients at the operation and extubation time (p = 0.39; r = -0.39).
Conclusion:
The surgical outcome of anterior mini-thoracotomy for PDA closure in neonates is compatible with good results. This technique may be advantageous for extremely low birth weight infants and results in less traction on the lungs.
