[Thoracic alterations after surgical closure of the ductus arteriosus botallo in preterm infants].
BACKGROUND
Left-sided thoracotomy for ligation of patent ductus arteriosus (PDA) dissects the musculus latissimus dorsi and notches a small part of the musculus trapezius. After ductal closure the 4 (th) and 5 (th) rib are adapted. This follow-up study investigated if mid- or long-term consequences on the thorax occur after this procedure.


METHODS
Status of the thoracic scar, functionality of the shoulder and presence of scapulata alata or scoliosis was evaluated at median age of 6 years (range: 2.9-11.9) in 57 pre-term infants (30 male; gestational age 26 weeks (24-32); birth weight 805 g (450-2140)).


RESULTS
Scoliosis was diagnosed in 1 patient (=1.8%) with Rubinstein-Taybi syndrome. The length of the thoracic scar (13.8 cm; 9.4-25.5) correlated with the patient's age (r=0.61; p=0.001). The scar was relocatable except for one case. The distance of the ventral end of the scar to the nipple was 2 cm or less in 22% of the female patients. None of the patients showed impaired function of the shoulder. Scapula alata was found in 16 (28%) patients.


CONCLUSIONS
Thoracotomy for PDA ligation was not associated with an increased risk for scoliosis or disturbed function of the shoulder. One quarter of all infants developed scapula alata which meant an aesthetic issue for some parents.
Trotter
A
A
Klinik für Kinder und Jugendliche, Hegau-Bodensee Klinikum, Singen, Germany. andreas.trotter@web.de
Larsch
F J
FJ
Hannekum
A
A
Pohlandt
F
F
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012540:Scapula; D012600:Scoliosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013908:Thoracotomy