We report a rare case of accidental clipping of the aorta during surgical ligation
of PDA in a premature infant.
Conclusion: The transcatheter closure of PDA is an effective and less invasive method as compared to the surgical ligation. There is a lower rate of complications and the cost is not much high as compared to surgical PDA ligation.
KEY WORDS: Surgical ligation, Patent ductus arteriosus.
Surgical ligation of PDA was 1st described in 1930s through lateral thoracotomy with good results.5 From past two decades, closure of PDA with latest generation devices has been performed with very good results in various age groups.6 PDA closure with Amplatzer duct occluder (ADO) has proved an excellent therapeutic option.7-10 The high cost of this device and other devices as compared to surgical ligation of PDA has limited their widespread use.
Surgical ligation was performed under general anesthesia in the operating room through lateral thoracotomy.
or embolization may be used to treat varices associated with pain or hematuria.
Previous reports after incomplete surgical ligation
or recanalization of the LAA have emphasized the potential for stagnant blood flow within the LAA and possible thrombus risk with systemic embolization (9,10).
Prior to the development of endovascular therapies such as stents, coils, and particle embolization, open surgical ligation
was the mainstay of therapy, even though it often resulted in significant neurologic morbidity.
Tetralogy of fallot with aortopulmonary collateral arteries in adults is complex in the pathophysiological condition, varies in the anatomical location.1 If the surgical ligation
APCAs is applied, it might result in a greater surgical trauma and need superb surgical skills.
Transcatheter closure of the PDA was suggested but the family preferred surgical ligation
. Thoracotomy without cardiopulmonary bypass revealed presence of small PDA and uneventful ligation of the PDA was performed at age of six months.
Because of the presence of effort dyspnea, limited functional capacity and regional myocardial ischemia, we planned surgical ligation
of the coronary-pulmonary fistulas in the course of the off- pump heart surgery.