title: Closure of a patent ductus arteriosus in pre-term neonates using a left anterior mini-thoracotomy.
abstract: OBJECTIVE
  We present a surgical technique for closure of a patent ductus arteriosus (PDA) in pre-term neonates. Left anterior mini-thoracotomy is a surgical procedure that consists of an anterior mini-thoracotomy (~1.5 cm) below the clavicle, clipping the PDA, and closing the thorax without a tube thoracotomy.
  
  
  METHODS
  Using this method between 2009 and 2012, we performed PDA closure in 32 pre-term neonates. Logistic regression analysis of potential risk factors for mortality was determined.
  
  
  RESULTS
  The mean weight of the patients at the operation was 822.81 ± 24.59. The mean age at the operation was 28.97 ± 2.20 days. No surgery-related mortalities occurred. Four short-term mortalities occurred after the operation (12.5%) before the patients could be discharged. Three were due to sepsis, and one was due to necrotizing enterocolitis. According to the linear regression analysis, no other variables were found to be statistically significant for predicting mortality. A negative linear correlation was found between the weight of the patients at the operation and extubation time (p = 0.39; r = -0.39).
  
  
  CONCLUSIONS
  The surgical outcome of anterior mini-thoracotomy for PDA closure in neonates is compatible with good results. This technique may be advantageous for extremely low birth weight infants and results in less traction on the lungs.
authors.affiliation: Cardiovascular Surgery Clinic, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Haydarpaşa, İstanbul, Turkey.
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Karaci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sasmazel
authors.forename: Saritas
authors.initials: S
authors.lastname: Turkay
authors.forename: Numan
authors.initials: N
authors.lastname: Aydemir
authors.forename: Bugra
authors.initials: B
authors.lastname: Harmandar
authors.forename: Harmandar
authors.initials: H
authors.lastname: Bugra
authors.forename: Hasan
authors.initials: H
authors.lastname: Erdem
authors.forename: Yekeler
authors.initials: Y
authors.lastname: Ibrahim
mesh_terms: D060666:Airway Extubation; D001724:Birth Weight; D001835:Body Weight; D004374:Ductus Arteriosus, Patent / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000401:mortality; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013908:Thoracotomy / Q000379:methods* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome