Ligature chirurgicale du canal artériel chez le prématuré de très petit poids de naissance

Ligation of the Patent Ductus Arteriosus in Premature Infants - Indications and Procedures

“…Pharmacologic management using indomethaein shows a 42 % failure rate in lhe literature reviewed (2, 3, 10). lt seems thal in high risk patients, under 1500 g, with severe respiratory distress syndrome, lrealment with indomethacin delayed operalion and appeared lo affect prognosis (8). Complieations ha\'e been described after indomethacin treatment such as: reduclion of renal perfusion \\'ilh varying degrees of renal dysfunclion, gaslroinleslinal bleeding, bleeding dyscrasias and hyperbilirubinemia by linkage bel\\'een indomethacin and plasma prolein .…”

“…The \'alue of ligation of PDA in lhe premature infanl wilh respiratory distress s}lldrome is now suppOlied by manyauthor (8,9). All agree lhat the procedure can be done with a very low operative risk and wilh a beller post-operative course.…”

“…To avoid this, it has been reeommended thal surgery be performed in a surgieal unit near the neonatal units, Therefore patients may be operated in lhe neonatal intensi\'e earl' unit with adapted equipment in an open ineubator. Ventilation, eonventional neonatal monitoring with transeutaneous oxygen level monitoring are neeessary (8). The ductus is approaehed through a lefL posterolateral thoraeotomy in the third intercostal space.…”