A Study of Clinical Profile and Management of Patients With Patent Ductus Arteriosus

Abstract

BACKGROUND PDA is an abnormal persistence of a patent lumen in the foetal ductus arteriosus that usually connects the upper descending thoracic aorta with the proximal portion of the left pulmonary artery. The aim of the study is to study the clinical profile of patients with patent ductus arteriosus, role of various investigation modalities, various surgical treatment options available and overall morbidity and mortality. MATERIALS AND METHODS The retrospective study includes 60 cases of patent ductus arteriosus admitted for a period of 5 years. RESULTS The PDA is more common in females with female-to-male ratio of 2.75:1. Premature infants with PDA become symptomatic earlier as compared to full-term infants. Because of the late presentation, majority of the patients were symptomatic in the present study, and in symptomatic patients, symptoms of breathlessness of varying NYHA-class and recurrent respiratory tract infections were the commonest symptoms. Accentuated pulmonary sound, hyperactive precordium, murmur were the most signs. Chest x-ray and ECG are the important investigation in the diagnosis of PDA. Echocardiogram was the most commonly used diagnostic modality and was diagnostic in all cases. Echocardiogram does give an accurate assessment of PDA, but ultimately intraoperative assessment of PDA is the most important to decide about the surgical technique of closure. Chylothorax was seen in 3 patients. The overall mortality in the present study was 3%. CONCLUSION Surgical closure of PDA can be accomplished with low morbidity and mortality.