Patent ductus arteriosus treatment in the premature newborn: clinical and surgical analisys.
BACKGROUND
The surgical treatment of patency ductus arteriosus is indicated when the clinical intervention fails. However, this treatment may have some complications.


OBJECTIVE
To analyze clinical and surgical aspects involved on the treatment of patency ductus arteriosus in premature newborn.


METHODS
Twenty two premature newborns, submitted to surgical treatment for patency ductus arteriosus from January, 2000 to June, 2006, were evaluated. There were 77.3% female patients, the mean birth weight was 952.5 g and the mean gestational age was 27 weeks. The use of vasoactive drugs, indometacin, echocardiograph parameters and complications, in the pre and postoperative periods were evaluated.


RESULTS
In this casuistic 59.1% patients needed intratracheal intubation at birth, 77.3% needed surfactants, 59.1% used vasoactive drugs preoperative. The mean doses of indometacin were 3.43, with dose range 0.1 to 0.25 mg/Kg/day. The mean caliber of arterial duct patent was 1,96 mm. The surgical procedure was carried out through extrapleural approach in 59.1% of the patients, the mean time of postoperative intubation was 30.9 days, and 50% of the patients used vasoactive drugs postoperative. There were 18.1% postoperative complications (postoperative non-fatal complications).


CONCLUSIONS
More than the half of the patients needed intratracheal intubation at birth, surfactant use and vasoactive drugs in the preoperative period. There was greater prevalence of the extrapleural approach during the surgery. In the postoperative period, there was less demand of vasoactive use and there was not deaths related to the surgical procedure.
Universidade Federal de São Paulo, São Paulo, SP, Brasil. rafael.locali@hotmail.com
Rafael Fagionato
RF
Locali
Priscila Katsumi
PK
Matsuoka
Edmo Atique
EA
Gabriel
Ayrton
A
Bertini Júnior
Carlos Arnulfo
CA
La Rotta
Roberto
R
Catani
Antônio Carlos de Camargo
AC
Carvalho
Enio
E
Buffolo
D001938:Brazil / Q000453:epidemiology; D004374:Ductus Arteriosus, Patent / Q000401:mortality / Q000601:surgery*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D054238:Perinatal Mortality; D011183:Postoperative Complications; D011184:Postoperative Period; D011300:Preoperative Care; D012189:Retrospective Studies