Mehmet Taşar1, Nur Dikmen Yaman2, Zeynep Eyileten2, Begüm Atasay3, Ercan Tutar4, Semra Atalay4, Adnan Uysalel2
1Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
2Departments of Pediatric Cardiovascular Surgery, Medical Faculty of Ankara University, Ankara, Turkey
3Departments of Neonatology, Medical Faculty of Ankara University, Ankara, Turkey
4Departments of Pediatric Cardiology, Medical Faculty of Ankara University, Ankara, Turkey
Keywords: Cardiac surgery; infant; patent ductus arteriosus; prematurity; very low birth weight
Objectives: We aimed to present our institutional experience on the surgical management of low birth weight infants with patent ductus arteriosus.
Patients and methods: In this retrospective study, 14 low birth-weight infants with a mean birth weight of 1201±252 g (range, 640 to 1500 g), mean age of 19.71±9.55 days (4 to 38 days), mean gestational age of 29.14±2.07 weeks (25 to 34 weeks) operated for isolated patent ductus arteriosus (mean weight on operation of 1377 g) between January 2008 and November 2012 were included. At baseline, all patients received indomethacin and three were also given ibuprofen. None achieved closure of the duct. Standard surgical protocol consisting of suture closure of patent ductus arteriosus through posterolateral thoracotomy approach was performed in all patients.
Results: The mean operation time was 70.4±18.8 min, the mean mechanical ventilation time was 10.6±7.4 h, the mean intensive care unit stay was 7.4 days (range, 1 to 38 days), and the mean hospital stay was 12.8±11.5 days (range, 4 to 44 days). There was no complication, mortality or morbidity related to surgery. Reintubation rate was 14.28% and this complication resolved with surfactant therapy.
Conclusion: Early intervention for closure of isolated patent ductus arteriosus is acceptable in very low birth weight infants who are unresponsive to medical treatment provided that no other abnormality is present and the surgical protocol is well standardized.