[Need for surgical ligation of patent ductus arteriosus among patients treated at the Neonatology Department of the University of Medical Sciences, Poznan, Poland].
OBJECTIVE
Clinical assessment of newborns requiring surgical ligation of patent ductus arteriosus (PDA).


METHODS
51 newborns operated on PDA in Department of Neonatology in Poznań in years 2000 and 2001. Newborns were classified for surgical ligation after echocardiographic examination (ACUSON 128 XP/10 or HDI 3500, sector scanhead 5MHz). Following data were analyzed: antenatal steroid therapy, gestational age, birth weight, Apgar score, the reason of respiratory insufficiency after birth, duration of mechanical ventilation and oxygen therapy, incidence of bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH) and deaths.


RESULTS
30 of 51 analyzed patients had very low birth weight (< or = 1000 g). Antenatal steroids were used in 21 cases, 20 newborns were delivered by caesarean section. The status of 22 newborns was assessed after birth as bad (0-3 points in Apgar scale). In 38 newborns respiratory distress syndrome was diagnosed and 32 required surfactant therapy. Surgical ligation of PDA was performed on 19.8 +/- 14.4 day of life in neonates born in our hospital and on 24.3 +/- 11.9 day of life in newborns admitted for ligation from other wards. Surgery of one patient was complicated by pneumothorax. 42 patients required mechanical ventilation before operation. Mean duration of mechanical ventilation was 33.4 +/- 26.9 days. 30 infants developed BPD and 15 infants IVH III or IV degree, 6 infants died.


CONCLUSIONS
PDA is a serious clinical problem especially for very low birth weight newborns. Surgical ligation of a PDA, without transportation of a patient, is associated with a low incidence of complications.
Matuszczak-Wleklak
Marzena
M
Katedry i Kliniki Neonatologii, Akademii Medycznej im. Karola Marcinkowskiego w Poznaniu.
Szymankiewicz
Marta
M
Gadzinowski
Janusz
J
D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008026:Ligation / Q000706:statistics & numerical data; D008168:Lung / Q000503:physiopathology; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*