Tratamento da persistência de canal arterial em recém-nascidos prematuros: análise clínica e cirúrgica

Locali, Rafael Fagionato; Matsuoka, Priscila Katsumi; Gabriel, Edmo Atique; Júnior, Ayrton Bertini; Rotta, Carlos Arnulfo La; Catani, Roberto; Ac, Carvalho; Buffolo, Ênio

doi:10.1590/s0066-782x2008000500007

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…On the premature, the incidences can variate to 20% to 60%, depending on the diagnostic standards used and the population studied 16,17 , but on average, around 50% of all preterm infants presents patent ductus arteriosus 5,7,9,11,12 . The gestational age and the weight when born are deeply connected to patent ductus arteriosus in preterm neonates 18 .…”

Section: Extreme Low Weight 1000g or Lessmentioning

confidence: 99%

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Preterm newborns undergoing selective correction surgery of the patent ductus arteriosus: is there still space for these procedures?

Prado¹,

Camacho²,

Paredes³

et al. 2019

jhgd

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Introduction: The ductus arteriosus is a small fetal structure that connects two large arteries (aorta and pulmonary) but becomes pathological when it is maintained after birth. Morbidities associated with persistent patent ductus arteriosus (PDA) may lead to the conclusion that the best approach is early surgical treatment. However, there is evidence that expectant (more selective) surgical management may reduce the chances of unnecessary surgeries and their risks. Objective: To analyze the clinical and surgical profile of preterm newborns submitted to selective correction surgery of the patent ductus arteriosus. Method: This paper contemplates a series of cases, in which all patients submitted to the surgical treatment of PDA in preterm infants were described retrospectively (2009-2016), through the analysis of medical records of the Santa Marcelina Hospital, SP-Brazil. Results: During this period, there were 13 cases of premature infants who underwent selective surgical correction of PDA. Gestational age was 26.92 weeks, maternal age ranged from 15 to 44, birth weight varied between 650 and 1500g, mostly women (61.54%). The diameter of the ductus arteriosus ranged from 1.7 to 4.1 mm, four patients had complex congenital heart disease (30.77%). The median courses of indomethacin were 1.77, congestive heart failure was shown in 11 patients (84.62%), the median age at surgery was 27.69 days and the median duration of orotracheal intubation was 22.62 days. The weight of the newborns at the time of the surgical act varied between 900 and 1820g. The postoperative complications were mostly infectious, with nine patients with bronchopneumonia (69.23%), one patient had pneumothorax. Sepsis occurred in two cases (15.35%) that died due to the same complication (15.35%). Conclusion: All preterm newborns who underwent surgery had birth weight less than 1500g. The median arterial canal was 3.05 mm in diameter. The median gestational age was 26.92 weeks and 62% of the cases were female. The most frequent surgical technique was the triple clipping, there was no bleeding or reoperation in this series of cases. ge at surgery was 27.69 days and the median duration of orotracheal intubation was 22.62 days. The weight of the newborns at the time of the surgical act varied between 900 and 1820g. The postoperative complications were mostly infectious, with nine patients with bronchopneumonia (69.23%), one patient had pneumothorax. Sepsis occurred in two cases (15.35%) that died due to the same complication (15.35%). Conclusion: All preterm newborns who underwent surgery had birth weight less than 1500g. The median arterial canal was 3.05 mm in diameter. The median gestational age was 26.92 weeks and 62% of the cases were female. The most frequent surgical technique was the triple clipping, there was no bleeding or reoperation in this series of cases.

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Section: Extreme Low Weight 1000g or Lessmentioning

confidence: 99%

“…Cardiovascular system changes are frequent on the preterm infant and among them, the patent ductus arteriosus being the one most mentioned [5][6][7][8][9][10][11][12] (Chart 1 and 2).…”

Section: Introductionmentioning

confidence: 99%

Preterm newborns undergoing selective correction surgery of the patent ductus arteriosus: is there still space for these procedures?

Prado¹,

Camacho²,

Paredes³

et al. 2019

jhgd

View full text Add to dashboard Cite

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Surgical Treatment of Open Ductus Arteriosus in Premature Infants

Aleksi-Meskhishvili

Kozlov

2018

Russian Journal of Pediatric Surgery

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The choice of tactics for the treatment of open arterial duct (OAD) in newborns is one of the most controversial and debatable topics in neonatal medicine. There are several approaches in the treatment of OAD in small infants: 1) the prophylactic use of cyclooxygenase inhibitors; 2) treatment on the background of maintenance therapy without the medical and surgical intervention; 3) drug stimulation of the closure of the AOA; 4) surgical intervention. Surgical treatment, which can be done with the aid of the open surgery and thoracoscopy, still plays a leading role. Complications associated directly with the operation are minimal. In this study, we present a review of the literature, including current information on the most frequent complications arising from the surgical treatment of OAD in newborns - damage to the lungs with the development of pneumothorax, damage to the great vessels with circulatory disorders, wound to the left phrenic nerve followed by paresis of the left diaphragm dome, damage to the recurrent nerve with impaired function of the left vocal cords, damage to the thoracic lymphatic duct with the development of chylothorax, damage to the muscles with development of functional scoliosis. Special attention is paid to the prognosis of the course of the disease and the survival rate of low birth weight infants.

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Tratamento da persistência de canal arterial em recém-nascidos prematuros: análise clínica e cirúrgica

Cited by 2 publications

References 15 publications

Preterm newborns undergoing selective correction surgery of the patent ductus arteriosus: is there still space for these procedures?

Preterm newborns undergoing selective correction surgery of the patent ductus arteriosus: is there still space for these procedures?

Surgical Treatment of Open Ductus Arteriosus in Premature Infants

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