Terlemez Semiha, Işık Onur, Şahin Suzan, Akcan Abdullah Barış, Kaynak Türkmen Münevver
Adnan Menderes University Medıcıne Faculty, Pediatrıc Cardıology Department, Aydın, Turkey.
Tepecik Training and Research Hospital, Cardiovascular Surgery Department, İzmir, Turkey
Heart Surg Forum. 2017 Dec 22;20(6):E266-E268. doi: 10.1532/hsf.1707.
The inadvertent ligation of the left pulmonary artery (LPA) is a rarely seen surgical complication that has been presented in the literature in a limited number of cases after patent ductus arteriosus (PDA) ligation surgery. Case Report: A PDA closure operation was performed on our patient, a 28-week-old preterm. In the postoperative follow-up, we identified on echocardiography taken on the same postoperative day that the ductus space was still present. On CT angiography, we determined that not only was the ductus space still continuing, but, in addition, ligation of the LPA had been performed inadvertently. An LPA reconstruction operation was performed on the patient 46 days after the first operation. However, owing to severe tissue damage in LPA, LPA reperfusion did not occur in the postoperative period. Conclusion: Although inadvertent ligation of the left pulmonary artery during PDA ligation surgery is rarely seen in patients who have undergone closure surgery, this complication should be kept in mind in the postoperative follow-up period. Patient findings such as physical examination, lung angiography and postoperative echocardiography should be assessed with this in mind.
左肺动脉意外结扎是一种罕见的手术并发症，在动脉导管未闭（PDA）结扎手术后的文献中仅有少数病例报道。病例报告：我们为一名28周龄的早产儿实施了PDA闭合手术。术后随访时，在术后同一天进行的超声心动图检查中，我们发现动脉导管间隙仍然存在。在CT血管造影检查中，我们确定不仅动脉导管间隙仍在延续，而且还意外地结扎了左肺动脉。在首次手术后46天，为该患者实施了左肺动脉重建手术。然而，由于左肺动脉严重的组织损伤，术后左肺动脉未实现再灌注。结论：尽管在接受闭合手术的患者中，PDA结扎手术期间左肺动脉意外结扎很少见，但在术后随访期间应牢记这一并发症。应结合这一点对体格检查、肺部血管造影和术后超声心动图等患者检查结果进行评估。
