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ISMICS 2025 Annual Meeting
28 - 31 May, 2025 | Istanbul, Turkey
D140
Use Of An Automated Knot Fastner For Patent Ductus Arteriosus Ligation In The Preterm Neonate
Part of Topic
Pediatric - Cardiac, Cardiovascular & Thoracic
Video
Use of an Automated Knot Fastener For Patent Ductus Arteriosus Ligation In the Preterm Neonate
Kang Min Kim, Seung RiKang, Woosik Han
Department of Thoracic and Cardiovascular Surgery, Chung-ang University Gwangmyeong Hospital, Gwangmyeong, Korea, Republic of.
BACKGROUND
§Surgical treatment of patent ductus arteriosus (PDA) in preterm neonates can be performed either by ligation with a ligature or by applying a metal clip.
§Using metal clip carries the riskof impingement on adjacent structures such as the left pulmonary artery, recurrent laryngeal nerve or the aorta itself, leading to coarctation of the aorta.
§Suture or tie ligation of PDA could be difficult because of the small size of the thoracic cavity in premature neonates.
Micro-Knot Fastener
§Automated micro-knot fastener for polypropylene suture with USP sized 6-0, 7-0, or 8-0
Facilitates secure knot tying in restricted surgical field
Figure 1. Automated micro-knot fastener device
Case
§A 35-year-old primigravida underwent cesarean section at 27 + 6 weeks of gestation due to preeclampsia, delivering a male neonate weighing 870 grams.
§The neonate developed respiratory distress syndrome and was diagnosed with a large PDA, measuring 4mm in diameter.
§At postmenstrual age 30+6 weeks (22 days of life), PDA ligation was performed via left thoracotomy (2.5 cm).
§The PDA was ligated using polypropylene suture 7-0 and automated micro-knot fastener.
§The patient recovered well and was discharged on day of life 92
Figure 2. Video clip of PDA ligation using micro-knot fastener
Figure 3. Micro-knot fastener size comparison
Conclusion
§The newly developed automated micro-knot fastener device, offers significant advantages in the surgical management of PDA in extremely low birth weight premature neonates, where operative space is severely limited.
§It’s utility may be further expanded to other pediatric cardiac surgeries.