Illusions leading to surgical closure of the distal left pulmonary artery instead of the ductus arteriosus

Pontius, Robert G.; Danielson, Gordon K.; Noonan, Jacqueline A.; Judson, John Paul

doi:10.1016/s0022-5223(19)39396-1

Cited by 21 publications

(10 citation statements)

References 16 publications

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“…Because, this manoeuvre can cause confusion of the patent ductus arteriosus and left pulmonary artery. 8,9 In patients whose vascular anatomy is suspected to be abnormal, intraoperative echocardiography should be planned and performed to avoid this complication. The right lateral decubitus positioning during the surgical procedure allows echocardiography examination on the right side of the patient under the sterile surgical area.…”

Section: Discussionmentioning

confidence: 99%

Ligation of left pulmonary artery instead of patent ductus arteriosus

Yücel

Şahin

2020

Cardiol Young

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Ductus arteriosus is an essential component of fetal circulation. Due to occurring changes in the cardiopulmonary system physiology after birth, ductus arteriosus closes. Patent ductus arteriosus can be closed by medical or invasive (percutaneous or surgical) treatment methods. Percutaneous or surgical closure of patent ductus arteriosus can be performed for the cases that medical closure failed. Surgical treatment is often preferred method for closure of patent ductus arteriosus in the neonatal period. The most common surgical complications are pneumothorax, recurrent laryngeal nerve injury, bleeding, and recanalisation. A very rare surgical complication is left pulmonary artery ligation that has been presented in a few cases in the literature. Echocardiography control should be performed in the early post-operative period, especially in patients with clinical suspicion. If reoperation is required, it should never be delayed. We report a newborn patient whose left pulmonary artery ligated accidentally during patent ductus arteriosus closure surgery and surgical correction of this complication at the early post-operative period.

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Section: Discussionmentioning

confidence: 99%

Ligation of left pulmonary artery instead of patent ductus arteriosus

Yücel

Şahin

2020

Cardiol Young

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“…Surgical closure of a large PDA has been associated with significant complications, including recurrent laryngeal nerve injury, aortic dissection, and left pulmonary artery ligation [8–10]. Additionally, the repair of such a lesion in an adult is often complicated by calcification of the ductus requiring the use of cardiopulmonary bypass because of concerns of ductal rupture during simple ligature or attempts at division.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of a very large patent ductus arteriosus in a pregnant woman at 22 weeks of gestation

Kanter

Hellenbrand

Pass

2003

Cathet Cardio Intervent

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“…Inadvertent ligation of the left pulmonary artery (LPA) during attempted surgical closure of a Patent Ductus Arteriosus (PDA) has long been recognized as one of the less common complications of this procedure [ 1 – 3 ]. In a large series by Panagopoulos et al [ 4 ], containing 936 surgical closure of PDA, there was 1 inadvertent left pulmonary artery ligation.…”

Section: Introductionmentioning

confidence: 99%

Inadvertent ligation of the left pulmonary artery during intended ductal ligation

2015

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BackgroundInadvertent ligation of the left pulmonary artery during attempted surgical closure of a Patent Ductus Arteriosus has long been recognized as one of the less common complications of this procedure. Surgical reconstruction of the left pulmonary artery was then often attempted but was difficult or impossible in some of the patients with hypoplasia of the left pulmonary artery and the left lung.Case presentationA 10-year-old girl presented with marked exercise intolerance and palpitations and was diagnosed to have large PDA. She had feeding difficulty, diaphoresis, failure to gain weight, recurrent chest infections during infancy and early childhood. Physical examination revealed an underweight child with wide pulse pressure and bounding peripheral pulses. She had active precordium with accentuated P2 and machinery murmur in the left 2nd intercostal space and mid diastolic rumble at the mitral area. Echocardiography showed a 12 mm patent arterial duct. She was taken for an intended surgical ligation of the duct but a control echocardiogram on the 3rd postoperative day revealed that the left pulmonary artery, instead of the duct, was ligated. Surgical reconstruction of the left pulmonary artery was undertaken 3 years later, however, this was complicated by post reconstruction left pulmonary artery stenosis. Successful percutaneous stenting of the left pulmonary artery was performed 18 months after the surgical reconstruction.ConclusionThe incidence of inadvertent LPA ligation may be underestimated where PDA ligation is done by less experienced surgeons and postoperative echocardiography is not routinely performed. Late correction of inadvertent LPA ligation is an important surgical challenge, especially if the duct is still patent. Percutaneous stenting as a primary option may carry significant risk, as the ligated pulmonary artery is fragile. In our case, a good result was achieved with surgical repair followed by percutaneous stenting.

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Illusions leading to surgical closure of the distal left pulmonary artery instead of the ductus arteriosus

Cited by 21 publications

References 16 publications

Ligation of left pulmonary artery instead of patent ductus arteriosus

Ligation of left pulmonary artery instead of patent ductus arteriosus

Transcatheter closure of a very large patent ductus arteriosus in a pregnant woman at 22 weeks of gestation

Inadvertent ligation of the left pulmonary artery during intended ductal ligation

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