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The Annals of Thoracic Surgery Aug 1992Concurrent aortic stenosis and patent ductus arteriosus are not infrequent in children but are rare in adults. An adult case is described with diagnosis by cardiac... (Review)
Review
Concurrent aortic stenosis and patent ductus arteriosus are not infrequent in children but are rare in adults. An adult case is described with diagnosis by cardiac catheterization and magnetic resonance imaging and with management by combined aortic valve replacement and patent ductus ligation. Review of the English-language literature produced only 8 such cases in adults, 2 of which were managed by a single-stage operation. Successful diagnosis in the adult requires careful observation at cardiac catheterization, and simultaneous valve replacement and ductus ligation may be a useful option in patient management.
Topics: Aged; Aortic Valve Stenosis; Ductus Arteriosus, Patent; Female; Humans
PubMed: 1637236
DOI: 10.1016/0003-4975(92)91406-y -
International Journal of Cardiology May 2011Patent ductus arteriosus (PDA) can occur as part of more congenital cardiac malformations or as an isolate finding. Spontaneous, transcatheter, surgical closure, and...
Patent ductus arteriosus (PDA) can occur as part of more congenital cardiac malformations or as an isolate finding. Spontaneous, transcatheter, surgical closure, and pharmacological treatment have been reported. We present a case of recurrent PDA after the initial course of a pharmacological treatment. Also this case focuses on recurrent PDA after the initial course of a pharmacological treatment.
Topics: Ductus Arteriosus, Patent; Humans; Infant; Male; Recurrence; Ultrasonography
PubMed: 19321210
DOI: 10.1016/j.ijcard.2009.02.017 -
Canadian Medical Association Journal Oct 1980Patent ductus arteriosus was diagnosed in 239 neonates of low birth weight (less than 2500 g) referred to the Hospital for Sick Children in a 21/2-year period. The...
Patent ductus arteriosus was diagnosed in 239 neonates of low birth weight (less than 2500 g) referred to the Hospital for Sick Children in a 21/2-year period. The respiratory distress syndrome was present in 77% of the group and congestive heart failure in 50%. Spontaneous closure of the defect was more frequent in those without congestive heart failure. In 48 patients whose heart failure could not be controlled by other medical therapy indomethacin was given, and in 20 (42%) it was judged successful. Surgical ligation of the ductus was performed at a median age of 30 days in 33 infants who either failed to respond to indomethacin or in whom its use was contraindicated; there were no intraoperative deaths, but 11 (33%) of the infants died 4 days to 6 months after the operation.
Topics: Ductus Arteriosus, Patent; Female; Heart Failure; Humans; Indomethacin; Infant, Low Birth Weight; Infant, Newborn; Male; Respiratory Distress Syndrome, Newborn
PubMed: 7448679
DOI: No ID Found -
Heart, Lung & Circulation Nov 2013Herein we report a 21 year-old woman with a previously documented patent ductus arteriosus and Eisenmenger physiology. She presented with increasing cyanosis and...
Herein we report a 21 year-old woman with a previously documented patent ductus arteriosus and Eisenmenger physiology. She presented with increasing cyanosis and exercise intolerance which could be explained by a new finding of right to left shunting through an interatrial communication. She was started on Bosentan therapy aiming to reduce the pulmonary pressure with consideration for heart-lung transplantation should any further deterioration occur.
Topics: Adult; Ductus Arteriosus, Patent; Eisenmenger Complex; Female; Humans
PubMed: 23583537
DOI: 10.1016/j.hlc.2013.03.071 -
Anesthesia and Analgesia Aug 2011
Topics: Adolescent; Cardiac Surgical Procedures; Catheterization; Ductus Arteriosus, Patent; Echocardiography; Echocardiography, Transesophageal; Endocarditis; Humans; Postoperative Complications; Pulmonary Artery
PubMed: 21788328
DOI: 10.1213/ANE.0b013e31821e9592 -
Cardiology in the Young Mar 2015Percutaneous closure of patent ductus arteriosus has become the treatment of choice in many centres. In patients with large ducts and pulmonary hypertension,...
BACKGROUND
Percutaneous closure of patent ductus arteriosus has become the treatment of choice in many centres. In patients with large ducts and pulmonary hypertension, transcatheter closure has been achieved with success using the Amplatzer Duct Occluder or even the Amplatzer Muscular Ventricular Septal Defect Occluder.
MATERIALS AND METHODS
We present a series of 17 patients with large and hypertensive ductus arteriosus who were treated with an Amplatzer Septal Occluder. The group had 11 female patients (64.7%) and a mean age of 18.6±12.1 years.
RESULTS
The haemodynamic and anatomical data are as follows: pulmonary artery systolic pressure 71.3±31.8 mmHg, pulmonary to systemic flow ratio 3.14±1.36, ductal diameter at the pulmonary end 12.5±3.8 mm, and at the aortic end 20.2±7.7 mm; 14 cases (82.3%) had type A ducts. In 11 patients, we began the procedure using a different device - six with duct occluder and five with ventricular septal occluder - and it was changed because of device embolisation in six (35.3%). All septal occluders were delivered successfully. Residual shunt was moderate in six patients (35.3%), mild in eight (47%), trivial in two (11.8%), and no shunt in one (5.9%). Pulmonary systolic pressure decreased to 48.9±10.8 mmHg after occlusion (p=0.0015). Follow-up in 15 patients (88.2%) for 28.4±14.4 months showed complete closure in all cases but one, and continuous decrease of the pulmonary systolic pressure to 31.4±10.5 mmHg. No complications at follow-up have been reported.
CONCLUSIONS
The Amplatzer Septal Occluder is a good alternative to percutaneously treat large and hypertensive ductus arteriosus.
Topics: Adolescent; Adult; Blood Vessel Prosthesis; Cardiac Catheterization; Child; Child, Preschool; Ductus Arteriosus, Patent; Female; Follow-Up Studies; Hemodynamics; Humans; Hypertension, Pulmonary; Male; Septal Occluder Device; Treatment Outcome; Young Adult
PubMed: 24555910
DOI: 10.1017/S1047951114000183 -
Circulation Sep 1993Several devices are available for transcatheter occlusion of patent ductus arteriosus. Most of these devices either require complicated intracardiac maneuvering, have... (Clinical Trial)
Clinical Trial
BACKGROUND
Several devices are available for transcatheter occlusion of patent ductus arteriosus. Most of these devices either require complicated intracardiac maneuvering, have not been tried in humans, or need a large-sized sheath for implantation of the device.
METHODS AND RESULTS
During a 26-month period ending November 1992, 14 patients underwent transcatheter closure of patent ductus arteriosus with an adjustable buttoned device delivered via a 7F sheath under an institutional review board-approved custom-made device protocol. The children were 15 months to 8 years of age with weight range of 7.2 to 19 kg. The patent ductus arteriosus measured from 2 to 7.5 mm (median, 3 mm) at the narrowest diameter and was conical, short, or tubular. They were occluded with devices measuring 15 to 20 mm. The ratio of pulmonary to systemic flow decreased (P < .01) from 1.9 +/- 0.6 (mean +/- SD; range, 1.3 to 3.2) to 1.05 +/- 0.1 (1 to 1.3). Continuous murmur of patent ductus arteriosus disappeared in all except 1 patient. Small residual shunts were detected by color Doppler studies in 4 of 14 patients (29%). All patients were followed for 1 to 24 months (mean, 6 +/- 7 months). The device was intact in all patients, and no breakage of the wires was noted. No shunts were seen in 12 of 14 patients (86%), and minute residual shunts were seen in 2 children. No major complications were encountered.
CONCLUSIONS
It is concluded that transcatheter closure of patent ductus arteriosus with the adjustable buttoned device is feasible and effective and can be accomplished via small 7F sheaths; a 7F sheath is adequate for all ductal sizes; and the adjustable length of the loop accommodated all types of patent ductus arteriosus. Clinical trials on a larger number of patients are warranted.
Topics: Cardiac Catheterization; Catheterization; Child; Child, Preschool; Ductus Arteriosus, Patent; Equipment Design; Follow-Up Studies; Humans; Infant; Prostheses and Implants; Radiography; Time Factors
PubMed: 8353873
DOI: 10.1161/01.cir.88.3.1119 -
Journal of Cardiac Surgery Mar 1994Two cases of patent ductus arteriosus (PDA) and aortic stenosis are presented. Both were diagnosed at routine cardiac catheterization and significant aortic gradient was... (Review)
Review
Two cases of patent ductus arteriosus (PDA) and aortic stenosis are presented. Both were diagnosed at routine cardiac catheterization and significant aortic gradient was concomitantly encountered. The first patient had subacute bacterial endocarditis due to B. cereus infection. Eventually it was proven to be localized on the PDA on the pulmonary artery side. Both patients underwent closure of PDA through endopulmonary closure and aortic valve replacement. Postoperative courses were uneventful. These cases demonstrated the technically easy closure of the PDA in the elderly. The literature has documented only six cases including our two cases.
Topics: Age Factors; Aged; Aortic Valve Stenosis; Cardiac Catheterization; Coronary Angiography; Ductus Arteriosus, Patent; Female; Humans; Male
PubMed: 8012105
DOI: 10.1111/j.1540-8191.1994.tb00830.x -
Cardiology in the Young Nov 2017In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical... (Comparative Study)
Comparative Study
BACKGROUND
In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical outcomes may depend on the accuracy of diagnosis and the timing of administration. The objective of the present study was to characterise the association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants.
METHODS
This retrospective cohort study used electronic health record data on inborn infants of gestational age ⩽28 weeks and birth weight <1500 g who were discharged after day of life 7 from 362 neonatal ICU from 1997 to 2013. The primary outcome was death between day of life 7 and discharge. Secondary outcomes included bronchopulmonary dysplasia, necrotising enterocolitis, and grade 3 or 4 intraventricular haemorrhage.
RESULTS
This study included a total of 48,551 infants with a median gestational age of 27 weeks (interquartile range 25, 28) and birth weight 870 g (706, 1050). Early echocardiography - that is, performed during days of life 2 to 6 - was performed in 15,971/48,551 (33%) infants, and patent ductus arteriosus was diagnosed in 31,712/48,551 (65%). The diagnosis was more common in infants who had undergone early echocardiography (14,549/15,971 [91%] versus 17,163/32,580 [53%], p<0.001). In multivariable analysis, early echocardiography was not associated with reduced mortality (odds ratio 0.97, 95% CI 0.89-1.05). Results were similar in the subset of infants who received therapy for patent ductus arteriosus (odds ratio 1.01, 95% CI 0.90-1.15).
CONCLUSIONS
Early echocardiography was associated with an increased diagnosis of patent ductus arteriosus, but not with decreased mortality.
Topics: Comorbidity; Ductus Arteriosus, Patent; Early Diagnosis; Echocardiography; Electronic Health Records; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Intensive Care Units, Neonatal; Logistic Models; Male; Retrospective Studies; Treatment Outcome
PubMed: 28625190
DOI: 10.1017/S1047951117001081 -
Early Human Development 1992An overview is presented of 21 randomised controlled trials of either surgical closure of the ductus arteriosus or indomethacin therapy in preterm infants. All trials... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
An overview is presented of 21 randomised controlled trials of either surgical closure of the ductus arteriosus or indomethacin therapy in preterm infants. All trials included backup treatment if the ductus arteriosus persisted. Overall, there is no significant effect on mortality or chronic lung disease. In trials treating at a presymptomatic stage, there is a trend to reduce the incidence of chronic lung disease. Early treatment with indomethacin reduces the incidence of periventricular haemorrhage. An ultrasound study of 110 very low birth weight infants showed ductus arteriosus size at 3 days to be related to factors reflecting the infants' condition (ventilation indices, blood product administration), but not to birth weight or gestational age. Infants with a moderate to large ductus arteriosus at 3 days had a significantly lower blood pressure from 12 h of age onwards than those with a closed or small ductuses.
Topics: Ductus Arteriosus, Patent; Humans; Hypotension; Incidence; Infant, Newborn; Infant, Premature, Diseases; Meta-Analysis as Topic; Randomized Controlled Trials as Topic
PubMed: 1396254
DOI: 10.1016/0378-3782(92)90179-k