Surgical closure of patent ductus arteriosus in premature neonates: Experience of a Mobile Pediatric Cardiac Surgery Unit

Objectives. To evaluate the results of patent ductus arteriosus closure in premature neonates operated on at the bedside, in a Neonatal Intensive Care Unit. Methods. From January 1990 to June 2005, 47 premature neonates underwent closure of a symptomatic patent ductus arteriosus; surgery was performed in the Neonatal Intensive Care Unit, at the patients' bedside, by our Mobile Pediatric Cardiac Surgery Unit. Mean gestational age at birth was 26 ± 2.2 weeks (23-35) and mean weight was 0.9 ± 0.3 Kg (0.4-2.3 Kg). The surgical staff was composed by two pediatric cardiac surgeons, one pediatric cardiac anaesthesiologist and one cardiac operating room nurse. Results. All patients survived the surgical procedure and the complete interruption of ductal flow was obtained in 100% of cases. Three patients died during hospitalization (6.4%) for non procedure-related causes. Conclusions. Our results confirm the low incidence of morbidity and mortality in the surgical approach to patent ductus arteriosus in premature neonates. Performing the operation in the Neonatal Intensive Care Unit is safe and feasible without increasing risk, and can work to the advantage of both patients and families.