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2010, Number 1

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Rev Mex Cir Pediatr 2010; 17 (1)

Experience in the surgical closure of ductus arteriosus in a Permeable Neonatal Intensive Care Unit (NICU) of a Level 2 Hospital in Guadalajara, Jal. Mexico

Gallardo-Meza AF, González-Sánchez JM, Piña-Garay MA, Medina-Andrade MA, Cabrera-Rojas H, Lozano RA, Rivera-Camacho JF, González-Flores F, Vázquez-Jackson H

Language: Spanish
References: 20
Page: 19-23
PDF size: 183.36 Kb.


ABSTRACT

Introduction: The ductus arteriosus is the most common congenital heart disease in preterm infants. His prognosis is poor if left to natural evolution, as it causes irreversible lung damage and excellent if it serves a timely manner by closing the canal. Objectives: To review the evolution and morbidity in patients undergoing surgical closure of patent ductus arteriosus in a neonatal intensive care unit over a period of two years five months.
Material and Methods: The history, clinical outcome, diagnostic methods and open surgical management of 31 patients with patent ductus arteriosus October 2006 to March 2009. Surgery was performed on 31 patients, survival was 84%.
Results: The gestational age (GA) was ‹ 30 weeks in 6, between 30 and 32, and 12 patients between 32 and 35, 13 patients. Extrauterine age at the time of surgery was 15 days on average. 53.8% (14) studied with hyaline membrane disease of varying degrees. 76.9% (20) studied with variable degrees of pulmonary hypertension. The echocardiogram confirmed the diagnosis in 100% of patients. Complications: 41% pleural tear. Death in 5 patients. No cases died during the surgical procedure, or because of it.
Conclusions: The surgical closure resulted is a useful option with low morbidity, feasible to conduct a Level 2 hospital, where there is a neonatal intensive care unit and a pediatric surgeon with good training. It is a relatively simple surgical procedure with minimal complications. It is of great use surgery when indications for pharmacological closure is not possible, either by the terms of the child or because of being out for this age


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