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ORIGINAL ARTICLE

Surgical treatment of patent ductus arteriosus in low-weight child and neonates

Ciro Denevitz de Castro HerdyI; Fued Michel AbílioI; Nelson VieiraI; Sérgio Blanes BrancaglionI; Leonardo Silveira de CastroI; Júlio César Peclat de OliveiraI; Carlos Alberto M PintoI; João B ThomazI; Sérgio L. de AzevedoI

DOI: 10.1590/S0102-76381996000300006

ABSTRACT

The patent ductus arterious frequently occurs in premature neonates causing serious cardiopulmonary disfunction. The treatment includes two options; one clinic and the other surgical procedure. The surgery for patent ductus arteriosus has been done since 1938. Clinical treatment with indometacin induces closure of the arteriosus ductus. The aim of the article is to analize the surgical results with thoractomy by triple-ligature of the ductus for the treatment of persistent ductus arteriosus in fourteen patients including low weight children and premature neonates with cardiopulmonary disfunction. The indications for surgery in these cases were respiratory distress and congestive heart failure. The technique used was triple-ligature of the patent ductus arteriosus. There were no complications neither mortality. The Neonate Intensive Care Unit was important for the evolution of these patients. Our study showed good results achieved by this technique, with low mortality and morbidity and the importance of the Intensive Care Unit for the evolution of these patients.

RESUMO

A persistência do canal arterial ocorre com freqüência em neonatos prematuros, provocando um grave quadro de disfunção cardiopulmonar. O tratamento envolve duas abordagens, sendo uma clínica e outra cirúrgica. A operação para a ligadura do canal arterial é praticada desde 1938. O enfoque clínico preconiza o uso da indometacina, com o intuito de promover a oclusão do canal arterial. O presente trabalho tem por objetivo avaliar os resultados obtidos com o tratamento cirúrgico da persistência do canal arterial, através de toracotomia e ligadura em 14 pacientes, incluindo crianças de baixo peso e neonatos prematuros com quadro clínico instável. A principal indicação cirúrgica, nestes casos, foi a presença de insuficiência respiratória aguda e insuficiência cardíaca. A técnica empregada foi a tripla ligadura do canal arterial. Nos 14 casos não obtivemos nenhum tipo de complicação e sem mortalidade. A presença de uma Unidade de Tratamento Intensivo Neonatal (U.T.I) no Hospital foi de extremo valor no preparo dos pacientes e na evolução no período de pós-operatório. Este trabalho comprova a eficácia do método cirúrgico empregado, com baixas taxas de morbidade e mortalidade e a importância da U.T.I neonatal no acompanhamento dos pacientes.
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