Abstract
BackgroundPatent ductus arteriosus is a common congenital cardiac condition. Its importance is mostly underestimated and accepted as an “easy” heart disease. Physiological consequences of pulmonary overflow may cause severe mortality in premature neonates. Accurate timing of surgical intervention is essential to decrease the mortality in very low birth weight premature infants. On-site surgery in the intensive care units (ICUs) results excellent surgical quality without jeopardizing the safety of the patients.MethodsWe have summarized the clinical and operative data of 26 premature neonates (<37 weeks of gestational age), which were operated for the diagnosis of PDA in the ICUs of Dokuz Eylül University. Thirteen low birth weight infants (<1000 gr) have been compared with remaining 13 neonates (>1000 gr).ResultsThere was no surgical mortality in both groups. Co-existing problems were observed in both groups, which did not affect surgical mortality and morbidity.ConclusionsSurgery in the ICU is a safe method for premature neonates with physiologically significant PDA. This technique should be the method of choice in experienced centers.
Highlights
Patent ductus arteriosus is a common congenital cardiac condition
The consequences of a significant left-to-right shunting through the Patent ductus arteriosus (PDA) may present hemodynamic and respiratory importance [1,2]
Spontaneous closure of the PDA in normal birth weight neonates occurs in 3 days, but it may persist longer in prematures [3]
Summary
Patent ductus arteriosus is a common congenital cardiac condition. Its importance is mostly underestimated and accepted as an “easy” heart disease. Physiological consequences of pulmonary overflow may cause severe mortality in premature neonates. Accurate timing of surgical intervention is essential to decrease the mortality in very low birth weight premature infants. Patent ductus arteriosus (PDA) is a frequent congenital cardiac condition in low birth weight premature neonates. The consequences of a significant left-to-right shunting through the PDA may present hemodynamic and respiratory importance (chronic lung disease, intraventricular hemorrhage, necrotizing enterocolitis, retinopathy etc.) [1,2]. Spontaneous closure of the PDA in normal birth weight neonates occurs in 3 days, but it may persist longer in prematures [3]. Positive effects of early closure of shunting on cardiac and respiratory functions have been reported previously [4]. Systemic treatment options are the method of choice in many centers: Fluid restriction, continuous positive
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