Evaluating the Clinical Outcomes of Patent Ductus Arteriosus Surgical Closure in Yemeni Patients: A Retrospective Single-Center Study

Abstract

Background: Patent ductus arteriosus (PDA) surgical closure is a standard treatment approach for symptomatic neonates unresponsive to medical therapy. However, limited data on outcomes exist, particularly in resource-limited settings like Yemen. Purpose: This study aimed to evaluate isolated PDA surgical closure outcomes, including intensive care unit (ICU) stay, extubation, hospitalization, and postoperative complications. Methods: A retrospective study was conducted from May 2017 to May 2022 at Al-Thawra Modern General Hospital. Transthoracic echocardiography confirmed PDA diagnosis and assessed pulmonary hypertension severity. Results: A total of 290 patients underwent PDA closure, with the majority being female (65.5%, n=190) and infants (65.5%, n=190). The majority had moderate to severe pulmonary hypertension (61%, n=177). Primary intervention was PDA ligation with hemoclip application (82.1%, n=238). Most patients were extubated in the ICU (78.6%, n=228), discharged on the 5th day or earlier (90.3%, n=262), and 71% (n=206) required more than 12 hours in ICU. Complications occurred in 7.2% (n=21) of the cases, primarily residual duct issues and recurrent laryngeal nerve complications. Three cases (1.0%) resulted in non-surgery related deaths. Pulmonary hypertension significantly influenced hospital stay, extubation, and postoperative complications. Conclusion: Surgical PDA closure is safe and effective in Yemen. Pulmonary hypertension significantly influences outcomes, highlighting the importance of early detection and timely PDA management to prevent complications.