Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal.
Kathmandu Univ Med J (KUMJ). 2020 Apr-Jun;18(70):133-138.
Background Ductus arteriosus is a vascular structure which connects the roof of main pulmonary artery near the origin of the left branch pulmonary artery to the proximal descending aorta. Patent ductus arteriosus (PDA) closure is indicated for any patient who is symptomatic from left to right shunting. Objective To investigate the hospital outcomes of surgical closure of patent ductus arteriosus over last 19 years starting from the very first case of our center. Method This is a retrospective analysis of all patent ductus arteriosus treated surgically from August 2001 to July 2019. Patients who underwent isolated surgical closure of patent ductus arteriosus were included. Data have been presented in three different eras (Era 1: 2001-2007, Era 2: 2008-2013, and Era 3: 2014-2019) to see the trend of evolution of this surgery. Result A total of 901 patients aged 8.67±8.76 years under went patent ductus arteriosus surgical closure over last 19 years. Patients in the initial era 2001-2007 were significantly older compared with other 2 eras (p=0.000). Males accounted for 35.5% of all cases. Twenty percent had severe pulmonary artery hypertension.Duration of mechanical ventilation was 3.57±9.64 hours with ICU stay of 1.55±1.53 days, and hospital stay of 3.9±2.3 days. Overall in hospital mortality was 0.8%; for isolated patent ductus arteriosus diagnosis, mortality was 0.2%. Chylothorax was noted in 0.4%. Conclusion This is the first report to analyze surgical outcomes of patent ductus arteriosus ligation in our center. We have discussed the evolution of patent ductus arteriosus surgery in our center, and have shown favorable outcomes in terms of morbidity and mortality.
背景 动脉导管是一种连接肺动脉干顶部与降主动脉近段的血管结构。对于任何因左向右分流而出现症状的患者,均应进行动脉导管未闭(PDA)关闭术。
目的 研究我院首例 PDA 手术后 19 年来 PDA 手术治疗的住院结局。
方法 这是对 2001 年 8 月至 2019 年 7 月期间接受单纯手术 PDA 关闭术的所有 PDA 患者进行的回顾性分析。纳入仅接受单纯手术 PDA 关闭术的患者。数据分为 3 个不同时期(时期 1:2001-2007 年;时期 2:2008-2013 年;时期 3:2014-2019 年),以观察该手术的演变趋势。
结果 在过去 19 年中,共有 901 例年龄为 8.67±8.76 岁的患者接受了 PDA 手术关闭术。与后两个时期相比,时期 1(2001-2007 年)的患者年龄明显更大(p=0.000)。男性占所有病例的 35.5%。20%的患者存在严重肺动脉高压。机械通气时间为 3.57±9.64 小时,ICU 停留时间为 1.55±1.53 天,住院时间为 3.9±2.3 天。总的院内死亡率为 0.8%;对于单纯 PDA 诊断,死亡率为 0.2%。乳糜胸的发生率为 0.4%。
结论 这是首次分析我院 PDA 结扎手术治疗的住院结局的报告。我们讨论了我院 PDA 手术的演变,并显示了在发病率和死亡率方面的良好结局。