HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Coster, D. D. Articles by Soltanzadeh, H. Search for Related Content PubMed PubMed Citation Articles by Coster, D. D. Articles by Soltanzadeh, H.

The Annals of Thoracic Surgery, Vol 48, 386-389, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Surgical closure of the patent ductus arteriosus in the neonatal intensive care unit

DD Coster, ME Gorton, RK Grooters, KC Thieman, RF Schneider and H Soltanzadeh
Department of Surgery, Iowa Methodist Medical Center, Des Moines 50309.

Efficacy of surgical closure versus indomethacin for treatment of patent ductus arteriosus in symptomatic neonates is an ongoing controversy. In recent years, surgical closure has been performed in the neonatal intensive care unit rather than the operating room in some centers, creating further controversy. In a retrospective study of the charts of 115 sequential patent ductus arteriosus surgical closures performed in the neonatal intensive care unit in premature infants, we found no surgical morbidity or mortality. Ninety-nine of these infants of less than 33 weeks gestational age were evaluated for various factors that might influence outcome. All were operated on within 72 hours of diagnosis, with an extra-pleural approach and metal clips used for closure of the ductus. All infants were extubated at an average of 33 weeks in each age group studied unless they had underlying severe bronchopulmonary dysplasia. We conclude that surgical closure of the symptomatic patent ductus arteriosus in neonates is safe and 100% effective, with none of the reported complications of indomethacin therapy, and should be the treatment of choice in neonates aged less than 33 weeks (gestational age) at birth with symptomatic patent ductus arteriosus. Closure performed in the neonatal intensive care unit eliminates transport risks and is ultimately safer and easier than transport to an operating room.

This article has been cited by other articles:

				S. Jaillard, B. Larrue, T. Rakza, E. Magnenant, H. Warembourg, and L. Storme Consequences of Delayed Surgical Closure of Patent Ductus Arteriosus in Very Premature Infants Ann. Thorac. Surg., January 1, 2006; 81(1): 231 - 234. [Abstract] [Full Text] [PDF]

				B. Korbmacher, S. Lemburg, N. Zimmermann, H. Stannigel, E. Godehardt, A. Heusch, J.D. Schipke, and E. Gams Management of the persistent ductus arteriosus in infants of very low birth weight: early and long-term results Interactive CardioVascular and Thoracic Surgery, September 1, 2004; 3(3): 460 - 464. [Abstract] [Full Text] [PDF]

				D. S. Gould, L. M. Montenegro, J. W. Gaynor, S. P. Lacy, R. Ittenbach, P. Stephens, J. M. Steven, T. L. Spray, and S. C. Nicolson A Comparison of On-Site and Off-Site Patent Ductus Arteriosus Ligation in Premature Infants Pediatrics, December 1, 2003; 112(6): 1298 - 1301. [Abstract] [Full Text] [PDF]

				S. S. Li, S. A. Xu, Y. R. Zheng, and X. W. Zhao Surgical Interruption of Patent Ductus Arteriosus in Children Asian Cardiovasc Thorac Ann, March 1, 1998; 6(1): 34 - 36. [Abstract] [Full Text] [PDF]

				A. W D Gavilanes, E. Heineman, M. J H M Herpers, C. E Blanco;, and D. BURGE Use of neonatal intensive care unit as a safe place for neonatal surgery • Commentary Arch. Dis. Child. Fetal Neonatal Ed., January 1, 1997; 76(1): 51F - 53. [Abstract] [Full Text]

				F. Laborde, T. Folliguet, A. Batisse, A. Dibie, E. Da-Cruz, D. Carbognani, and S. b. J. N. Cunningham VIDEO-ASSISTED THORACOSCOPIC SURGICAL INTERRUPTION: THE TECHNIQUE OF CHOICE FOR PATENT DUCTUS ARTERIOSUSRoutine experience in 230 pediatric cases J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1681 - 1685. [Abstract] [Full Text]