Demirturk Orhan, Güvener Murat, Coşkun Isa, Tünel Hüseyin Ali
Department of Cardiovascular Surgery, Baskent University Adana Medical Center, Adana, Turkey.
Pediatr Cardiol. 2011 Dec;32(8):1164-7. doi: 10.1007/s00246-011-0050-5. Epub 2011 Jul 14.
Minithoracotomy for extrapleural closure of the patent ductus arteriosus (PDA) in seriously ill patients offers a fast and less invasive alternative to conventional transpleural ductal closure. This study reports the immediate postoperative clinical outcomes for 24 extrapleurally clipped premature infants presenting with congestive heart failure in high-risk comorbidity status between March 2007 and November 2010. The demographics, preoperative clinical characteristics, and postoperative outcomes of the patients, including echocardiographic assessments, were evaluated. No surgery-related mortalities occurred. Four mortalities occurred after surgery due to sepsis and bleeding diathesis. All 20 surviving patients exhibited normal left ventricular dimensions and systolic function in the immediate follow-up period. The study shows that extrapleural clip closure in seriously ill premature infants has an acceptable overall short-term mortality and complication rate with a high rate of ductal closure.
对于重症患者，经胸小切口行动脉导管未闭（PDA）胸膜外闭合术为传统经胸膜导管闭合术提供了一种快速且侵入性较小的替代方法。本研究报告了2007年3月至2010年11月期间24例因合并症处于高危状态而出现充血性心力衰竭的早产婴儿经胸膜外结扎术后的即时临床结果。对患者的人口统计学、术前临床特征及术后结果进行了评估，包括超声心动图评估。未发生与手术相关的死亡病例。术后有4例因败血症和出血素质死亡。所有20例存活患者在近期随访期左心室大小和收缩功能均正常。该研究表明，重症早产婴儿经胸膜外结扎闭合术总体短期死亡率和并发症发生率可接受，导管闭合率高。
