Left Ventricular Dysfunction Post-surgical Patent Ductus Arteriosus Ligation in Children: Predictor Factors Analysis
Condition: Congenital Heart Disease in Children
MeSH terms: Heart Diseases; Heart Defects, Congenital; Ventricular Dysfunction; Ductus Arteriosus, Patent; Ventricular Dysfunction, Left
Study type: Observational [Patient Registry]

Summary: 
      Background:

      PDA is viewed as a standout amongst the most widely recognized congenital heart defects in
      children and its closure is responsible for many hemodynamic changes that require
      intervention and care.

      Methods:

      A retrospective study included fifty children with isolated PDA treated by surgical ligation
      from June 2015 to June 2018. Their mean age was 15.78 ± 7.58 months and 72% were females. The
      LV dimensions and systolic function were assessed by two-dimensional echocardiography pre PDA
      ligation. The mean duct size was 4.08 ± 1.25 mm.
    

Detailed description: 
      Methods:

      Study population Fifty children with PDA, for whom surgical PDA ligation was done from June
      2015 to June 2018. All cases were operated in cardiothoracic surgery department and were
      followed up by cardiothoracic surgeons and paediatricians at cardiac surgery ICU, Qena
      University Hospital. Their mean age at intervention was 15.78 ± 7.58 months, body surface
      area (BSA) 0.43±0.03 and 32 (72%) were females. The mean duct diameter was 4.08 ± 1.25 mm.
      The study conforms to the ethical standards of the Helsinki Declaration and approval was
      obtained from the institutional ethics committee of Qena Faculty of Medicine.

      Surgical technique PDA ligation was performed under general anaesthesia after pre-operative
      anaesthetic evaluation. After single endotracheal tube anaesthesia induction; children were
      placed on the right lateral recumbent position fixed with adhesive plaster and a pad under
      the chest, the left arm raised above the head. A left mini-thoracotomy incision is done
      parallel to the medial border of the scapula and entrance to the thoracic cavity was via the
      third or fourth intercostal space. Cautiously, the ductus is identified and dissected
      carefully. Then it was doubly ligated with silk ligature (2/0 or 0). An intercostal tube
      inserted during operation and removed within 48 hours if no drainage presents.

      Descriptive statistical analysis Data were arranged and analyzed utilizing Version 20 of the
      SPSS program (Statistical Package for Social Sciences). Continuous variables were compared
      using the Student paired t-test and are expressed as mean values ± standard deviation.
      Pearson Chi-Square tests were used to detect differences among groups for categorical
      variables. The relationship between PDA size and changes in echocardiographic parameters was
      verified using the Pearson linear correlation and the linear regression analysis. P-value of
      <0.05 was considered of significance.
    

Observational model: Cohort
Time perspective: Other
Sampling method: Probability Sample
Study population: 
        All cases were operated in cardiothoracic surgery department and were followed up by
        cardiothoracic surgeons and paediatricians at cardiac surgery ICU, Qena University
        Hospital.
      
Keywords: PDA; Echo