Pediatric Cardiology

, Volume 32, Issue 8, pp 1164–1167 | Cite as

Results From Extrapleural Clipping of a Patent Ductus Arteriosus in Seriously Ill Preterm Infants

  • Orhan Demirturk
  • Murat Güvener
  • Isa Coşkun
  • Hüseyin Ali Tünel
Original Article


Minithoracotomy for extrapleural closure of the patent ductus arteriosus (PDA) in seriously ill patients offers a fast and less invasive alternative to conventional transpleural ductal closure. This study reports the immediate postoperative clinical outcomes for 24 extrapleurally clipped premature infants presenting with congestive heart failure in high-risk comorbidity status between March 2007 and November 2010. The demographics, preoperative clinical characteristics, and postoperative outcomes of the patients, including echocardiographic assessments, were evaluated. No surgery-related mortalities occurred. Four mortalities occurred after surgery due to sepsis and bleeding diathesis. All 20 surviving patients exhibited normal left ventricular dimensions and systolic function in the immediate follow-up period. The study shows that extrapleural clip closure in seriously ill premature infants has an acceptable overall short-term mortality and complication rate with a high rate of ductal closure.


Extrapleural surgical clipping of ductus Patent ductus arteriosus Premature (preterm) infant 


  1. 1.
    Jaillard S, Larrue B, Rakza T, Magnenant E, Waremburg H, Storme L (2006) Consequences of delayed surgical closure of patent ductus arteriosus in very premature infants. Ann Thorac Surg 81:231–235PubMedCrossRefGoogle Scholar
  2. 2.
    Chen H, Weng G, Chen Z, Wang H, Xie Q, Bao J, Xiao R (2011) Comparison of posterolateral thoracotomy and video-assisted thoracoscopic clipping for the treatment of patent ductus arteriosus in neonates and infants. Pediatr Cardiol 32:386–390PubMedCrossRefGoogle Scholar
  3. 3.
    Friedman WF, Hirschklau MJ, Printz MP, Pitlick PT, Kirkpatrick SE (1976) Pharmacologic closure of patent ductus arteriosus in the premature infant. N Engl J Med 295:526–529PubMedCrossRefGoogle Scholar
  4. 4.
    Katakam L, Cotten CM, Goldberg RN, Dang CN, Smith PB (2010) Safety and effectiveness of indomethacin versus ibuprofen for treatment of the patent ductus arteriosus. Am J Perinatol 27:425–429PubMedCrossRefGoogle Scholar
  5. 5.
    Yao JK, Mustard WT (1969) The extrapleural ligation of patent ductus arteriosus in the seriously ill infant. Angiology 20:585PubMedCrossRefGoogle Scholar
  6. 6.
    Leon-Wyss J, Vida V, Veras O, Vides I, Gaitan G, O’Connell M, Castaňeda AR (2003) Modified extrapleural ligation of patent ductus arteriosus: a convenient surgical approach in a developing country. Ann Thorac Surg 79:632–635CrossRefGoogle Scholar
  7. 7.
    Iwase J, Tajima K, Io A, Katoh W, Tanaka K, Toki S, Iwasa M, Sobajima H, Takasu H, Yamada Y (2003) Less invasive surgical closure of patent ductus arteriosus in extremely low-birth-weight infants. Jpn J Thorac Cardiovasc Surg 51:651–655PubMedCrossRefGoogle Scholar
  8. 8.
    Alexander F, Chiu L, Kroh M, Hammel J, Moore J (2009) Analysis of outcome in 298 extremely low-birth-weight infants with patent ductus arteriosus. J Pediatr Surg 44:112–117PubMedCrossRefGoogle Scholar
  9. 9.
    Vida VL, Lago P, Salvatori S, Boccuzo G, Padalino MA, Milanesi O, Speggiorin S, Stellin G (2009) Is there an optimal timing for surgical ligation of patent ductus arteriosus in preterm infants? Ann Thorac Surg 87:1509–1516PubMedCrossRefGoogle Scholar
  10. 10.
    Mazzera M, Brancaccio G, Feltri C, Michielon G, Di Donato R (2002) Minimally invasive surgical closure of patent ductus arteriosus in premature infants: a novel approach. J Card Surg 17:292–294PubMedCrossRefGoogle Scholar
  11. 11.
    Vicente WA, Rodrigues AJ, Ribeiro PJ, Évora PR, Menardi AC, Ferreira CA, Alves L, Bassetto S (2004) Dorsal minithoracotomy for ductus arteriosus clip closure in premature neonates. Ann Thorac Surg 77:1105–1106PubMedCrossRefGoogle Scholar
  12. 12.
    Mandhan P, Brown S, Kukkady A, Samarakkody U (2009) Surgical closure of the patent ductus arteriosus in preterm low-birth-weight infants. Congenit Heart Dis 4:34–37PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Orhan Demirturk
    • 1
  • Murat Güvener
    • 1
  • Isa Coşkun
    • 1
  • Hüseyin Ali Tünel
    • 1
  1. 1.Department of Cardiovascular SurgeryBaskent University Adana Medical CenterAdanaTurkey

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