Chung Yoon Sang, Cho Dai Yun, Kang Hyun, Lee Na Mi, Hong Joonhwa
Department of Thoracic and Cardiovascular Surgery, Chung-Ang University Hospital.
Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital.
Korean J Thorac Cardiovasc Surg. 2017 Aug;50(4):242-246. doi: 10.5090/kjtcs.2017.50.4.242. Epub 2017 Aug 5.
Patent ductus arteriosus (PDA) ligation is usually performed by congenital cardiac surgeons. However, due to the uneven distribution of congenital cardiac surgeons in South Korea, many institutions depend solely on adult cardiac surgeons for congenital cardiac diseases. We report the outcomes of PDA ligations performed by adult cardiac surgeons at our institution.
The electronic medical records of 852 neonates at Chung-Ang University Hospital, Seoul, South Korea from November 2010 to May 2014 were reviewed to identify patients with PDA.
Of the 111 neonates with a diagnosis of PDA, 26 (23%) underwent PDA ligation. PDAs were ligated within 28 days of birth (mean, 14.5±7.8 days), and the mean gestational age of these patients was 30.3±4.6 weeks (range, 26 to 40 weeks) with a mean birth weight of 1,292.5±703.5 g (range, 480 to 3,020 g). No residual shunts through the PDA were found on postoperative echocardiography. There was 1 case of 30-day mortality (3.8%) due to pneumonia, and 6 cases of in-hospital mortality (23.1%) after 30 days, which is comparable to results from other centers with congenital cardiac surgery programs.
Although our outcomes may not be generalizable to all hospital settings without a congenital cardiac surgery program, in select centers, PDA ligations can be performed safely by adult cardiac surgeons if no congenital cardiac surgery program is available.
动脉导管未闭(PDA)结扎术通常由先天性心脏病外科医生进行。然而,由于韩国先天性心脏病外科医生分布不均,许多机构在处理先天性心脏病时完全依赖成人心脏外科医生。我们报告了我院成人心脏外科医生进行PDA结扎术的结果。
回顾了2010年11月至2014年5月在韩国首尔崇实大学医院的852例新生儿的电子病历,以确定患有PDA的患者。
在111例诊断为PDA的新生儿中,26例(23%)接受了PDA结扎术。PDA在出生后28天内进行结扎(平均14.5±7.8天),这些患者的平均胎龄为30.3±4.6周(范围26至40周),平均出生体重为1292.5±703.5克(范围480至3020克)。术后超声心动图未发现通过PDA的残余分流。有1例(3.8%)因肺炎在30天内死亡,30天后有6例(23.1%)住院死亡,这与其他有先天性心脏病手术项目的中心的结果相当。
虽然我们的结果可能不适用于所有没有先天性心脏病手术项目的医院环境,但在特定中心,如果没有先天性心脏病手术项目,成人心脏外科医生可以安全地进行PDA结扎术。