Alcántara-Noguez C , Medina-Andrade MÁ , Trujillo-Ponce SA , Aguirre-Jáuregui OM , López-Taylor JG , Guzmán-Montes de Oca RA , Hernández-Flores MS

Language: Spanish
References: 12
Page: 68-72
PDF size: 568.08 Kb.

ABSTRACT

Introduction: The patent ductus arteriosus (PDA), is the most frequent congenital heart disease on newborns. The incidence in premature is closely related with a high morbidity and mortality, ranking nowadays as a public health growing problem. The surgical closure of the PDA is indicated when it generates a significant short circuit, which is manifested by the dilation of the left cavity associated or not to heart failure. The objective of the study is to show the results of surgical closure of the patent ductus arteriosus performed by pediatric surgeons in training.
Material and methods: A prospective, descriptive study during June of 2009 and March of 2012. 22 patients with PDA, had their perinatal background, associated pathologies, ultrasonographic diagnostic criteria, surgery time, surgical technique and morbidity and mortality analyzed. Three stages of training were designed, on the starting stage the general attending physician (AP) participated as a surgeon, the 4th year pediatric surgeon in training (PST) as first assistant and the 3rd year PST as 2nd assistant. The training stage, in which the AP participated as first assistant, the 4 yr PST as surgeon and the 3 yr PST as second assistant, lastly, on the advanced stage the 4 yr PST was the surgeon, 3 yr PST the first assistant and the AP was the second assistant.
Results: The average age at the time of the surgery was 1.9 months. 12 patients had associated heart disease and congenital anomalies associated in another 4. The surgical average time was 67.7 min, the approach was thoracoscopic and open. The survival was 90.9%. None of the adverse events or mortality were associated to the surgical procedure.
Conclusion: The surgical closure of PDA is a concluding procedure with low morbidity and mortality that can be performed even in the bed of the patient when the adequate conditions are met. It is a procedure of easy reproduction by the pediatric surgeon who has previously received an adequate training of surgical competence. This kind of training shortens the pre operatory stay and diminishes the neonatal morbidity and mortality.

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