Surgical Closure of Isolated Patent Ductus Arteriosus in Cenhosoa Antananarivo

Abstract

Introduction: Patent ductus arteriosus (PDA) is a congenital heart disease whose seriousness lies in the risk of pulmonary hypertension, congestive heart failure and death. The aim of this study was to describe the surgical closure of an isolated patent ductus arteriosus (PDA) performed in Soavinandriana Teaching Hospital. Methods: This was a retrospective and descriptive study, during thirteen-years-period (January 2004 to December 2016), performed at Cardiac surgery unit of Soavinandriana Teaching Hospital, including all children underwent surgical closures of an isolated PDA. Demographic data, birth weight, clinical signs, diagnostic imaging, time between diagnosis and surgery and hospital left stays were analyzed. Results: A total of eighty-six children were recorded, including 21 males (24.42%) and 65 females (75.58%), giving sex ratio of 30%. The average age was 33.91 months. Children were born with a low birth weight in 12.79% of cases. PDA was symptomatic in 81.39%. The most circumstances of discovery were recurrent lung infections (31.40%), dyspnea (24.41%) and failure to thrive (19.76%). Echocardiography showed left ventricular dilatation (63.95%), pulmonary hypertension (73.25%). The ductus was large in 97.67% and the mean diameter was 5 mm. Chest X-ray showed cardiomegaly (97.67%) and increased pulmonary vascularity (86.04%). Mean delay of surgical procedures after diagnosis was 15.16 months. Surgical procedures consisted left posterolateral thoracotomy with a section and suture after clamping the ductus. Earlier postoperatives courses were simple in all children. The mean duration of hospitalization was 8.93 days. Conclusion: PDA