A Rare Complication of Patent Ductus Arteriosus Ligation: Inadvertent Ligation of the Left Pulmonary Artery

Authors

  • Semiha Terlemez Adnan Menderes University Medıcıne Faculty, Pediatrıc Cardıology Department, Aydın, Turkey
  • Onur Işık Tepecik Training and Research Hospital, Cardiovascular Surgery Department, İzmir, Turkey
  • Suzan Şahin Adnan Menderes University Medıcıne Faculty, Neonatology department, Aydın, Turkey
  • Abdullah Barış Akcan Adnan Menderes University Medıcıne Faculty, Neonatology department, Aydın, Turkey
  • Münevver Kaynak Türkmen Adnan Menderes University Medıcıne Faculty, Neonatology department, Aydın, Turkey

DOI:

https://doi.org/10.1532/hsf.1707

Abstract

Background: The inadvertent ligation of the left pulmonary artery (LPA) is a rarely seen surgical complication that has been presented in the literature in a limited number of cases after patent ductus arteriosus (PDA) ligation surgery. 

Case Report: A PDA closure operation was performed on our patient, a 28-week-old preterm. In the postoperative follow-up, we identified on echocardiography taken on the same postoperative day that the ductus space was still present. On CT angiography, we determined that not only was the ductus space still continuing, but, in addition, ligation of the LPA had been performed inadvertently. An LPA reconstruction operation was performed on the patient 46 days after the first operation. However, owing to severe tissue damage in LPA, LPA reperfusion did not occur in the postoperative period. 

Conclusion: Although inadvertent ligation of the left pulmonary artery during PDA ligation surgery is rarely seen in patients who have undergone closure surgery, this complication should be kept in mind in the postoperative follow-up period. Patient findings such as physical examination, lung angiography and postoperative echocardiography should be assessed with this in mind. 

Author Biography

Onur Işık, Tepecik Training and Research Hospital, Cardiovascular Surgery Department, İzmir, Turkey

Cardiovascular Surgery Department

References

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Jaffe RB, Orsmond GS, Veasy LG. 1986. Inadvertent ligation of the left pulmonary artery. Radiology 161:355–357.

Orzel JA, Monaco MP. 1986. Inadvertent ligation of the left pulmonary artery instead of patent ductus arteriosus. Noninvasive diagnosis by pulmonary perfusion imaging. Clin Nucl Med 11:629-631.

Panagopoulos PHG, Tatooles CJ, Aberdeen E, et al. 1971. Patent ductus arteriosus in infants and children: a review of 936 operations (1946–69). Thorax 26:137–144.

Pontius RG, Danielson GK, Noonan JA, Judson JP. 1981. Illusions leading to surgical closure of the distal left pulmonary artery instead of the ductus arteriosus. J Thorac Cardiovasc Surg 82:107–113.

Tefera E, Bermudez-Cañete R, van Doorn C. 2015. Inadvertent ligation of the left pulmonary artery during intended ductal ligation. BMC Res Notes 8:511.

Published

2017-12-22

How to Cite

Terlemez, S., Işık, O., Şahin, S., Akcan, A. B., & Kaynak Türkmen, M. (2017). A Rare Complication of Patent Ductus Arteriosus Ligation: Inadvertent Ligation of the Left Pulmonary Artery. The Heart Surgery Forum, 20(6), E266-E268. https://doi.org/10.1532/hsf.1707

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