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Publicación cuatrimestral editada por la Secretaría de Salud Jalisco

2018, Number 3

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Sal Jal 2018; 5 (3)

Experiencia en el cierre quirúrgico de ducto arterioso permeable, en un hospital de 2º nivel

Gallardo-Meza AF, González-Sánchez JM, Vidrio-Patrón F, Peña-Juárez A, Murguía-Guerrero H, Martínez-González MT, Ceja-Mejía OE, Medina-Andrade MÁ, Armas-Quiroz P, Arias-Uribe BN, Velarde-Briseño L, Vázquez-Jackson H, Mejía-Viveros CE

Language: Spanish
References: 25
Page: 135-143
PDF size: 536.89 Kb.


ABSTRACT

The Patent ductus arteriosus (PDA) is the most frequent congenital cardiac defect in newborns. Its incidence is high in premature newborns. Actually it is considered a public health problem in the neonatal intensive care units. Objetive: The aim of this paper is to show our experience with the surgical closure of PDA in a second level attention hospital with neonatal intensive care unit. Material and methods: We analyzed133 patients in which we performed a surgical closure of the PDA. We studied gender, gestational age, pulmonary hypertension, indication of surgery, surgical technique, extubation time in the post-operatory period, complications and mortality. Results: The 133 patients were newborns (24.1 to 41 weeks of gestational age), 72 patients were female and 77 were male. All the patients had the surgical closure of PDA, three by thoracoscopy and 130 by open left posterior lateral thoracothomy. None resulted in death during the surgical procedure and thirteen patients resulted in death, which represents a mortality rate of 9%,. Discusion: PDA is the most frecuent congenital cardiac defect in our hospital and is present in most premature newborns. The pharmacological closure of the PDA has precise indications, but when there are contraindications, surgical closure is mandatory. Conclusions: In second level attention hospitals who have a neonatal intensive care units, the surgical closure of PDA can be done by pediatric surgeons, the procedure is easy to perform it is reproductible with very few complications diminishing the morbility associated to this congenital heart disease. The post operatory mortality is similar or even less than literature reports in hospitals that have cardiothoracic pediatric surgeons


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