Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202301132
Jornal Vascular Brasileiro
Artigo Original

Surgical treatment of patent ductus arteriosus in different age groups

Tratamento cirúrgico da permeabilidade do canal arterial em diferentes faixas etárias

Abdurrahim Colak; Necip Becit; Ugur Kaya; Munacettin Ceviz

http://dx.doi.org/10.1590/1677-5449.202301132 J Vasc Bras, vol.24, e20230113, 2025
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Abstract

Background: Patent ductus arteriosus (PDA) is the continuation into postnatal life of a normal fetal vascular structure that makes an anatomical connection between the central pulmonary arterial system and the systemic arterial system.

Objectives: Patent ductus arteriosis (PDA) is a normal fetal vascular structure that makes a connection between the central pulmonary arterial system and the systemic arterial system, which is the continuation of the anatomical connection in postnatal life. In this study, we aimed to evaluate the results of PDA in our clinic with current literature.

Methods: In this study, data were reviewed retrospectively from 159 cases operated from 2000 to 2018 in the Department of Cardiovascular Surgery after diagnosis of PDA. Patients’ ages ranged from 3 days to 47 years and mean age was 5.48 (± 0.70) years. Seventy (44%) of these patients were female and 89 (56%) were male.

Results: The most common reason for admission of the patients included in the study was diagnosis at another health institution that referred them to our clinic. PDA interruption was achieved in 3 of them with a division technique. None of our patients entered total cardiopulmonary arrest. A ligation technique was used in 121 (76.1%) of the patients who underwent PDA closure with posterolateral thoracotomy. Seventy-five (47.1%) of the patients who underwent ligation were treated with a silk ligation technique; hemoclips and PDA elimination were employed in 21 (21.2%); and hemoclips and silk ligation were employed together in 25 patients (15.7%).

Conclusions: A surgical approach with thoracotomy for PDA closure is a treatment that can be employed successfully in children and adults as well as in older patients.

Keywords

PDA; ligation; division

Resumo

Contexto: A permeabilidade do canal arterial (PCA) é uma estrutura vascular fetal normal que liga o sistema arterial pulmonar central e o sistema arterial sistêmico, que é a continuação da conexão anatômica na vida pós-natal.

Objetivos: A persistência do canal arterial (PCA) é uma estrutura vascular fetal normal que estabelece uma conexão entre o sistema arterial pulmonar central e o sistema arterial sistêmico, sendo essa conexão anatômica uma continuidade na vida pós-natal. Neste estudo, objetivamos avaliar os resultados da PCA em nossa clínica, comparando-os com a literatura atual.

Métodos: Neste estudo, foram analisados retrospectivamente os dados de 159 casos de pacientes operados com o diagnóstico de PCA no Departamento de Cirurgia Cardiovascular entre 2000 e 2018. As idades dos pacientes variaram entre 3 dias e 47 anos e a média de idade era de 5,48 (± 0,70). Dos casos, 70 (44%) eram do sexo feminino e 89 (56%) do sexo masculino.

Resultados: O motivo mais comum de apelo dos pacientes incluídos no estudo era o resultado do diagnóstico de outra instituição de saúde e o encaminhamento para nossa clínica. Em três deles, obteve-se o fechamento da PCA pela técnica de divisão. Nenhum de nossos pacientes entrou em parada cardiorrespiratória total. A técnica de ligadura foi usada em 121 (76,1%) dos pacientes que foram submetidos ao fechamento da PCA com toracotomia posterolateral. Nos pacientes em que foi aplicada a técnica de ligadura, aplicou-se a técnica de ligadura de seda em 75 (47,1%), foram utilizados hemoclipes e fechamento da PCA em 21 (21,2%) e em 25 (15,7%) foram utilizados tanto hemoclipes quanto ligadura de seda.

Conclusões: A abordagem cirúrgica com toracotomia no fechamento da PCA é um tratamento que pode ser aplicado com sucesso em crianças, adultos e idosos.

Palavras-chave

 PCA; ligadura; divisão

Referências

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Submetido em:
24/07/2023

Aceito em:
02/10/2023

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