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

This Article Full Text Full Text (PDF) 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 Author home page(s): Juan Leon-Wyss Ivan Vides Aldo R. Castañeda Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leon-Wyss, J. Articles by Castañeda, A. R. Search for Related Content PubMed PubMed Citation Articles by Leon-Wyss, J. Articles by Castañeda, A. R. Related Collections Congenital - acyanotic

Ann Thorac Surg 2005;79:632-635
© 2005 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Modified Extrapleural Ligation of Patent Ductus Arteriosus: A Convenient Surgical Approach in a Developing Country

Unidad de Cirugia Cardiovascular de Guatemala (UNICAR), Guatemala Ciudad, Guatemala

Accepted for publication July 14, 2004.

^* Address reprint requests to Dr Vida, Unidad de Cirugia Cardiovascular de Guatemala (UNICAR), 9 Avenida, 8-00, Zona 11, Guatemala Ciudad, Guatemala (E-mail: vladimirovida{at}interfree.it).

BACKGROUND: Minimally invasive surgery for the closure of a large patent ductus arteriosus (PDA) using an extrapleural technique offers an alternative to other minimally invasive approaches such as video-assisted thoracoscopic surgery or interventional cardiologic procedures.

METHODS: Between August 1999 and December 2003, 513 patients with PDA were admitted to Unidad de Cirugia Cardiovascular de Guatemala, of whom 327 (64%) were considered surgical candidates. Of these, 218 (67%) were selected for surgical extrapleural (SEP) closure initially by weight (< 10 kg) and a ductal diameter at the pulmonary end of greater than 4 mm. Subsequently, we included also patients who weighed more than 10 kg. Median age at operation was 51 months (range 5 days to 38 years).

RESULTS: Median operating time was 32 minutes (range 23 to 52 minutes). All 218 patients had SEP closure and were extubated in the operating room. There were no hospital deaths. Two patients required a blood transfusion. Two additional patients bled postoperatively, requiring reoperation. A pneumothorax occurred in 3 patients that required a chest tube. The 6-month follow-up revealed residual ductal shunts in 2 patients that were closed percutaneously with a coil. The treatment of the remaining 295 patients included a surgical transpleural (STP) approach in 109 (37%) and transcatheter closure in 186 (63%), with a coil in 110 (37%) and an Amplatzer device in 76 (26%).

CONCLUSIONS: Minimally invasive closure of a PDA through a short, 3-cm to 5-cm skin and muscle-sparing posterior thoracotomy and an SEP approach provides a convenient and safe technique with a low incidence of complications and also a cost-saving option compared with other invasive techniques.

This article has been cited by other articles:

				B. Srinivasan, S. K. Thingnam, D. Das, and H. Singh Approach to Patent Ductus Arteriosus Ann. Thorac. Surg., August 1, 2006; 82(2): 769 - 769. [Full Text] [PDF]

				H. H. Dave, E. R. Valsangiacomo Buechel, and R. Pretre Muscle-Sparing Extrapleural Approach for the Repair of Aortic Coarctation Ann. Thorac. Surg., January 1, 2006; 81(1): 243 - 248. [Abstract] [Full Text] [PDF]

				S. I. Sersar, H. A. Mooty, M. M. Hafez, M. F. Ismail, A. A. Refaat, and M. F. Ibrahim PDA Ligation: Trans or Extrapleural Approach Ann. Thorac. Surg., November 1, 2005; 80(5): 1976 - 1976. [Full Text] [PDF]

				V. L. Vida and A. R. Castaneda Reply Ann. Thorac. Surg., November 1, 2005; 80(5): 1976 - 1977. [Full Text] [PDF]