Background: Patent ductus arteriosus is an important cause of morbidity and mortality especially in very low birth weight infants.The aim of the present study was to evaluate outcomes of bedside surgical ligation of patent ductus arteriosus via limited upper ministernotomy as an alternative approach to thoracotomy. Material and Method: A total of 23 low birth weight premature infants who underwent bedside ligation of PDA in the neonatal intensive care unit January 2017 to April 2020, were enrolled. The patients were divided into two groups: those with thoracotomy(n=13) and those with limited upper ministernotomy(n=10).These patients were evaluated retrospectively in terms of clinical and preoperative,intraoperative,postoperative parameters between the groups. Results: Mean birth weight was 1059±275 grams in the thoracotomy group and 1035±285 grams in the ministernotomy group. There was no statistically significant difference in the age at surgery,weight at surgery,preoperative MV support,inotropic score onset of surgery and total procedure time between the groups.There was a statistically significant difference in the hospital length of stay,postoperative MV time and complications in the intensive care unit in favor of the ministernotomy group(p=0.04,p=0.03,p=0.034 respectively).The study showed no statistically significant difference in the mortality rate between the two groups (2 patients in the thoracotomy group and 1 patient in the ministernotomy group). Conclusion:The limited upper ministernotomy is anatomically and technically feasible alternative to classical left posterolateral thoracotomy for bedside surgical PDA ligation.
PURPOSE: Systemic venous anomalies encompass a wide range of cardiovascular anomalies. Systemic venous anomalies are relatively infrequent and, under normal circumstances, asymptomatic, but may be clinical importance in cardiac surgery. This study aims to investigate whether systemic venous anomaly would have an effect on the any surgical planning. METHODS: We included a total of 525 consecutive patients (310 males, 215 females) who underwent open heart surgery for congenital heart disease. Patients were classified due to type of systemic venous anomalies. Demographic data and outcome data were retrospectively analyzed. RESULTS: Systemic venous anomaly was observed in 40 (13,25%) patients. The mean age and weight of the patients was 11.5 months (range, 1 day to 18 years), 9.3 kg (range, 500 gr-65 kg) respectively. Preoperative diagnosis was obtained in 14 / 40 (37.5%) patients with echocardiography, 12 / 40 (30%) with computed tomography scan, in 7 / 40 (17.5%) patients with conventional angiography and in 7/40 (17.5%) patients during surgery. A persistent left superior vena cava is the most common systemic venous anomaly (24 / 40 (60%) patients) and in others IVC interruption, retroaortic innominate vein and connection of PSSVC-LA was determined 7 / 40 patients (17.5%) , 4 / 40 patients (10%) and 4 / 40 patients (10%) respectively. No operative morbidity and complication associated with systemic venous anomalies was seen. CONCLUSION: Knowledge of the different course of the systemic venous anatomy prior to surgical intervention is important for the safe execution of any cardiac procedure.