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Bedside Patent Ductus Arteriosus Ligation in Premature Infants
Basak Soran Turkcan1, Atakan Atalay2, Davut Bozkaya3
1Department of Pediatric Cardiovascular Surgery, Gaziantep Cengiz Gokcek Maternal Health and Children Hospital, Gaziantep, Turkey.
Objective:
To determine the safety of on-site bedside patent ductus arteriosus (PDA) ligation, performed by a regional roving surgical team at different neonatal intensive care units (NICUs) in preterm infants with hemodynamically significant PDA (hsPDA).
Study Design:
A descriptive study.
Place And Duration Of Study:
Department of Paediatric Cardiovascular Surgery, Ankara City Hospital, Ankara, Turkey, between January 2018 and December 2020.
Methodology:
Medical data of 48 premature infants with hsPDA, who underwent bedside PDA ligation by the same roving surgical team at five different NICU centres in Ankara province, were evaluated. Demographic and clinical data of the patients were extracted from the institutional databases and medical records. Postoperative complications were recorded.
Results:
Mean body-weight of the infants was 1113.1 ± 392.8 grams. Forty patients were under respiratory support before surgery. Majority of the patients (n=45, 93.7%) no longer needed respiratory support after the third and seventh days of surgery. No complications related to surgery or anaestesia were observed. Non of the patients developed post-PDA ligation cardiac syndrome. No surgical wound infection or sepsis was observed in any patient. The overall mortality rate was 4.2%.
Conclusion:
Bedside PDA ligation at different NICUs by the roving surgical team is safe and effective. Owing to an extremely low risk, this procedure can be performed successfully in the hands of professional and experienced surgeons. It seems to be a feasible option for premature infants with hsPDA, who do not respond to medical treatment. Key Words: Infant, Patent ductus arteriosus, Ligation, Intensive care unit, Newborn, Surgery.
