Video-Assisted Ductal Ligation in Premature Infants

Michael H. Hines, Karen H. Raines, R. Mark Payne, Wesley Covitz, James F. Cnota, Timothy E. Smith, James J. O'Brien, Douglas G. Ririe, Kristine Guleserian, Erle H. Austin

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background. Video-assisted thoracic surgery has been shown to be a safe and effective method of closing the patent ductus arteriosus in infants and children. We have applied this technique in low birth weight premature infants and now report our experience. Methods. Since 1996, we have used video-assisted thoracic surgery ligation as the treatment of choice for all patent ductus arteriosus, including 100 performed on premature infants (23 to 31 weeks' gestation, mean 25.6 weeks; 0.420 to 1.5 kg, mean 0.859 kg). A modification of our previously described technique was used with a three-port approach. All patients had some degree of symptoms of congestive failure with failure to wean from ventilatory support or oxygen dependency. Five infants had associated patent foramen, and 1 had a small ventricular septal defect. Results. All 100 procedures were performed in the operating room. One infant was found to have a coarctation, and the procedure was aborted. The remaining 99 were successfully ligated, although three were converted to an open procedure (3%) because of coagulopathy, poor pulmonary compliance, or hemodynamic instability. There were no procedure-related deaths; however, 15 infants subsequently died of complications of prematurity, including enterocolitis, sepsis, and late respiratory failure. Six infants had chest tubes left in place for coagulopathy, effusions, suspected air leak, and existing empyema. There were six residual pneumothoraces, four requiring treatment. Conclusions. Video-assisted thoracic surgery is a safe and effective technique for patent ductus arteriosus ligation in premature infants, including those with very low and extremely low birth weight.

Original languageEnglish (US)
Pages (from-to)1417-1420
Number of pages4
JournalAnnals of Thoracic Surgery
Volume76
Issue number5
DOIs
StatePublished - Nov 2003

Fingerprint

Premature Infants
Ligation
Video-Assisted Thoracic Surgery
Patent Ductus Arteriosus
Low Birth Weight Infant
Enterocolitis
Lung Compliance
Chest Tubes
Empyema
Ventricular Heart Septal Defects
Pneumothorax
Operating Rooms
Respiratory Insufficiency
Sepsis
Hemodynamics
Air
Oxygen
Pregnancy
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Hines, M. H., Raines, K. H., Payne, R. M., Covitz, W., Cnota, J. F., Smith, T. E., ... Austin, E. H. (2003). Video-Assisted Ductal Ligation in Premature Infants. Annals of Thoracic Surgery, 76(5), 1417-1420. https://doi.org/10.1016/S0003-4975(03)00682-9

Video-Assisted Ductal Ligation in Premature Infants. / Hines, Michael H.; Raines, Karen H.; Payne, R. Mark; Covitz, Wesley; Cnota, James F.; Smith, Timothy E.; O'Brien, James J.; Ririe, Douglas G.; Guleserian, Kristine; Austin, Erle H.

In: Annals of Thoracic Surgery, Vol. 76, No. 5, 11.2003, p. 1417-1420.

Research output: Contribution to journalArticle

Hines, MH, Raines, KH, Payne, RM, Covitz, W, Cnota, JF, Smith, TE, O'Brien, JJ, Ririe, DG, Guleserian, K & Austin, EH 2003, 'Video-Assisted Ductal Ligation in Premature Infants', Annals of Thoracic Surgery, vol. 76, no. 5, pp. 1417-1420. https://doi.org/10.1016/S0003-4975(03)00682-9
Hines MH, Raines KH, Payne RM, Covitz W, Cnota JF, Smith TE et al. Video-Assisted Ductal Ligation in Premature Infants. Annals of Thoracic Surgery. 2003 Nov;76(5):1417-1420. https://doi.org/10.1016/S0003-4975(03)00682-9
Hines, Michael H. ; Raines, Karen H. ; Payne, R. Mark ; Covitz, Wesley ; Cnota, James F. ; Smith, Timothy E. ; O'Brien, James J. ; Ririe, Douglas G. ; Guleserian, Kristine ; Austin, Erle H. / Video-Assisted Ductal Ligation in Premature Infants. In: Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 5. pp. 1417-1420.
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abstract = "Background. Video-assisted thoracic surgery has been shown to be a safe and effective method of closing the patent ductus arteriosus in infants and children. We have applied this technique in low birth weight premature infants and now report our experience. Methods. Since 1996, we have used video-assisted thoracic surgery ligation as the treatment of choice for all patent ductus arteriosus, including 100 performed on premature infants (23 to 31 weeks' gestation, mean 25.6 weeks; 0.420 to 1.5 kg, mean 0.859 kg). A modification of our previously described technique was used with a three-port approach. All patients had some degree of symptoms of congestive failure with failure to wean from ventilatory support or oxygen dependency. Five infants had associated patent foramen, and 1 had a small ventricular septal defect. Results. All 100 procedures were performed in the operating room. One infant was found to have a coarctation, and the procedure was aborted. The remaining 99 were successfully ligated, although three were converted to an open procedure (3{\%}) because of coagulopathy, poor pulmonary compliance, or hemodynamic instability. There were no procedure-related deaths; however, 15 infants subsequently died of complications of prematurity, including enterocolitis, sepsis, and late respiratory failure. Six infants had chest tubes left in place for coagulopathy, effusions, suspected air leak, and existing empyema. There were six residual pneumothoraces, four requiring treatment. Conclusions. Video-assisted thoracic surgery is a safe and effective technique for patent ductus arteriosus ligation in premature infants, including those with very low and extremely low birth weight.",
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N2 - Background. Video-assisted thoracic surgery has been shown to be a safe and effective method of closing the patent ductus arteriosus in infants and children. We have applied this technique in low birth weight premature infants and now report our experience. Methods. Since 1996, we have used video-assisted thoracic surgery ligation as the treatment of choice for all patent ductus arteriosus, including 100 performed on premature infants (23 to 31 weeks' gestation, mean 25.6 weeks; 0.420 to 1.5 kg, mean 0.859 kg). A modification of our previously described technique was used with a three-port approach. All patients had some degree of symptoms of congestive failure with failure to wean from ventilatory support or oxygen dependency. Five infants had associated patent foramen, and 1 had a small ventricular septal defect. Results. All 100 procedures were performed in the operating room. One infant was found to have a coarctation, and the procedure was aborted. The remaining 99 were successfully ligated, although three were converted to an open procedure (3%) because of coagulopathy, poor pulmonary compliance, or hemodynamic instability. There were no procedure-related deaths; however, 15 infants subsequently died of complications of prematurity, including enterocolitis, sepsis, and late respiratory failure. Six infants had chest tubes left in place for coagulopathy, effusions, suspected air leak, and existing empyema. There were six residual pneumothoraces, four requiring treatment. Conclusions. Video-assisted thoracic surgery is a safe and effective technique for patent ductus arteriosus ligation in premature infants, including those with very low and extremely low birth weight.

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