Patent Ductus Arteriosus Surgery

Once the diagnosis of patent ductus arteriosus is determined, and no contraindications are available, surgery can be performed. The appropriate age for surgery is 2 to 6 years old. Treatment of diseases: pediatric patent ductus arteriosus, congenital patent ductus arteriosus, patent ductus arteriosus Indication Once the diagnosis of patent ductus arteriosus is determined, and no contraindications are available, surgery can be performed. The appropriate age for surgery is 2 to 6 years old. Preoperative preparation 1. Detailed physical examination and related examinations to clearly diagnose and exclude other malformations of the heart. 2. If there is heart failure, it should be corrected first; if combined with bacterial endocarditis, surgery should be performed 2 to 3 months after inflammation control. Surgical procedure (1) Arterial catheter ligation is suitable for young children. The catheter is slender, the wall is soft, the elasticity is large, and no bacterial infection occurs. 1. Incision: posterior lateral incision of the left chest. Go to the chest through the 4th or 5th intercostal space. 2. The left lower lobe is pulled forward and downward to reveal a triangular region of the catheter consisting of the left pulmonary artery, the phrenic nerve, and the vagus nerve. Continuous tremors can be seen in this area. 3. The longitudinal pleura is cut longitudinally between the phrenic nerve and the vagus nerve to reveal the catheter between the aorta and pulmonary artery. 4. The aorta at the upper and lower ends of the catheter is placed, and the blocking band is placed separately. 5. Carefully separate the front and upper and lower edges of the catheter, and then bluntly separate the posterior wall to avoid injury to the left recurrent nerve. Allow the catheter to have sufficient ligation length. 6. Use a finger to press or clamp the arterial catheter with a catheter clamp for about 10 minutes to perform a blocking test. If there is a drop in blood pressure, increased heart rate, arrhythmia, and elevated pulmonary pressure, the catheter should not be closed. Conversely, surgery can continue. 7. Under the guidance of a small right angle pliers, pass the two No. 10 wires through the back wall of the catheter. After the anesthesiologist reduced the blood pressure to 8 N10 kPa, the aortic end of the catheter was ligated first. The ligature should be gradually tightened gradually until the tremor of the pulmonary artery disappears, and then tightened slightly, and then the pulmonary artery side is ligated. It is also possible to sew 1 stitch between the two wires. 8. Stitch the mediastinal pleura. Place the thoracic closed drainage. Sucking, lungs. Stitch the chest wall incision. (B) Arterial catheterization suture is suitable for older children, catheters are thick and short, with a large flow or infected catheter. 1. Incision: posterior lateral incision of the left chest. Go to the chest through the 4th or 5th intercostal space. 2. The left lower lobe is pulled forward and downward to reveal a catheter consisting of the left pulmonary artery, the phrenic nerve, and the vagus nerve: the angular region. Continuous tremors can be seen in this area. 3. The longitudinal pleura is cut longitudinally between the phrenic nerve and the vagus nerve to reveal the catheter between the aorta and pulmonary artery. 4. The aorta at the upper and lower ends of the catheter is placed, and the blocking band is placed separately. 5. Carefully separate the front and upper and lower edges of the catheter, and then bluntly separate the posterior wall. Avoid injury to the left recurrent nerve during operation. 6. Place the Potts-Smith forceps on the aortic side; place 2 arterial forceps on the pulmonary artery side 7. While cutting the catheter, suture the aorta side continuously. 8. Suture the pulmonary artery side in the same way.