Monteiro Andrey José de Oliveira, Canale Leonardo Secchin, Rosa Rosie Vivian, Colafranceschi Alexandre Siciliano, Pinto Divino F, Baldanza Marcia, Barbosa Rosa Célia, Meier Milton Ary
Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.
Rev Bras Cir Cardiovasc. 2007 Jul-Sep;22(3):285-90. doi: 10.1590/s0102-76382007000300003.
To analyze the feasibility, the safety, and the primary outcomes of a minimally invasive thoracotomy for the occlusion of ligamentum arteriosum (ductus arteriosus) in preterm infants.
Between October 1991 and June 2003, 273 preterm infants and very low birth weight preterm infants were submitted to a surgical occlusion of the ligamentum arteriosum (ductus arteriosus) through muscle-sparing thoracotomy under general anesthesia in the neonatal ICU. Pre-operative demographic data, mortality outcomes, and adverse events were retrospectively analyzed through medical records consultation.
There were no deaths related to surgery, and 234 (86%) patients were discharged from hospital. Thirty-nine deaths have occurred between the 1st and the 51st days. The cause of death was sepsis (14 patients); intracranial bleeding (11 patients); and necrotizing enterocolitis (9 patients). All causes were related to prematurity. In five patients the cause of death was not established or could not be found in the medical records. The most frequent adverse events related to the surgery were: pneumothorax: 3.3% (9 patients), bleeding: 1.4% (4 patients).
The minimally invasive thoracotomy technique for the occlusion of the ligamentum arteriosum (ductus arteriosus) when performed in preterm infants and very low birth weight infants is feasible, safe, efficient, related to low morbidity, and not dependent of hospital resources.
分析在早产儿中采用微创开胸术闭合动脉韧带（动脉导管）的可行性、安全性及主要结局。
1991年10月至2003年6月期间，273例早产儿及极低出生体重早产儿在新生儿重症监护病房接受全身麻醉下经保留肌肉开胸术进行动脉韧带（动脉导管）手术闭合。通过查阅病历对术前人口统计学数据、死亡率结局及不良事件进行回顾性分析。
无手术相关死亡，234例（86%）患者出院。在第1天至第51天期间发生39例死亡。死亡原因包括败血症（14例患者）；颅内出血（11例患者）；坏死性小肠结肠炎（9例患者）。所有原因均与早产有关。5例患者的死亡原因未明确或在病历中未找到。与手术相关的最常见不良事件为：气胸：3.3%（9例患者），出血：1.4%（4例患者）。
在早产儿及极低出生体重儿中采用微创开胸术闭合动脉韧带（动脉导管）是可行、安全、有效的，发病率低，且不依赖医院资源。
