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Right arrow Congenital - acyanotic

J Thorac Cardiovasc Surg 2006;132:672-674
© 2006 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Comparison of suture ligation and clip application for the treatment of patent ductus arteriosus in preterm neonates

Parkash Lal Mandhan, MD, PhDa,*, Udaya Samarakkody, MD, FRACSa, Stuart Brown, MD, FRACSa, Askar Kukkady, MD, FRACSa, Kiki Maoate, MD, FRACSb, Russell Blakelock, MD, FRACSb, Spencer Beasley, MD, FRACSb

a Department of Paediatric Surgery, Waikato Hospital, Hamilton, New Zealand
b Department of Paediatric Surgery, Christchurch Hospital, Christchurch, New Zealand.

Received for publication December 20, 2005; revisions received March 24, 2006; accepted for publication April 3, 2006.

* Address for reprints: Parkash Lal Mandhan, MD, PhD, Waikato Hospital, Paediatric Surgery, Level 02, E. R. Building, Pembrook St, Hamilton 7524, New Zealand. (Email: sindhwasi{at}e3.net.nz).

OBJECTIVE: We reviewed the experience of 2 centers performing surgical ligation of patent ductus arteriosus in preterm neonates to identify whether the choice of surgical technique—suture ligation or clip application—affected outcome.

METHODS: Between 2000 and 2005, 67 newborn infants had open surgical closure of patent ductus arteriosus: 33 by suture ligation and 34 by clip application. The groups were similar in age and sex.

RESULTS: The average length of the procedure was 55.8 ± 13.7 minutes for suture ligation and 30.8 ± 8.7 minutes for clip application (P < .05). Six neonates had intraoperative bleeding in the suture ligation group. Four patients had significant postoperative complications in the suture ligation group, compared with 2 in the clip application group.

CONCLUSIONS: This study demonstrates that clip application results in a significant reduction in the operative time and, possibly, in less morbidity.

Abbreviations and Acronyms CA = clip application; PDA = patent ductus arteriosus; SL = suture ligation






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