The Role of Surgical Ligation of Patent Ductus Arteriosus in the Era of the Rashkind Device

Galal, Omar; Nehgme, Rodrigo; Al-Fadley, Frcp Fadel; Moor, Michael de; Abbag, Fuoad I; Al-Oufi, Mrcp Saud H; Williams, E. V.; Fawzy, Frcp Mohammed Eid; Al-Halees, Frcs Zohair

doi:10.1016/s0003-4975(96)00962-9

Cited by 22 publications

(3 citation statements)

References 19 publications

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“…One could argue that surgery might be preferred for this age group, but surgery is not without complications, including bleeding, pneumothorax, vocal cord paresis, diaphragm paralysis, bronchial compression, and ligation of left pulmonary artery and aorta. 14–16 The best univariate predictor of AEs was young age (<6 months). Interestingly, there was a trend of increased AEs with low body weight (<6 kg), pulmonary hypertension, and a complex cardiac defect besides a PDA.…”

Section: Discussionmentioning

confidence: 99%

Safety of Percutaneous Patent Ductus Arteriosus Closure: An Unselected Multicenter Population Experience

El‐Said

Bratincsák

Foerster

et al. 2013

JAHA

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BackgroundThe technique and safety of transcatheter patent ductus arteriosus (PDA) closure have evolved during the past 20 years. We sought to report a multicenter experience of PDA closure with a focus on the rate of adverse events (AE) and a review of institutional practice differences.Methods and ResultsOutcome data on transcatheter PDA closure were collected at 8 centers prospectively using a multicenter registry (Congenital Cardiac Catheterization Project on Outcome Registry). Between February 2007 and June 2010, 496 PDA closures were recorded using a device in 338 (68%) or coils in 158 (32%). Most patients had an isolated PDA (90%). Fifty percent of patients were between 6 months and 3 years old, with only 40 patients (8%) <6 months old. Median minimum PDA diameter was 2.5 mm (range 1 to 12 mm; IQR 2 to 3 mm) for device closure and 1 mm (range 0.5 to 6 mm; IQR 1 to 2 mm) for coil closure (P<0.001). A device rather than coil was used in patients <3 years, weight <11 kg, and with a PDA minimum diameter >2 mm (all P<0.001). Three of 8 centers exclusively used a device for PDAs with a diameter >1.5 mm. In 9% of cases (n=46), an AE occurred; however, only 11 (2%) were classified as high severity. Younger age was associated with a higher AE rate. Coil‐related AEs were more common than device‐related AEs (10% versus 2%, P<0.001).ConclusionsPDA closure in the present era has a very low rate of complications, although these are higher in younger children. Technical intervention‐related events were more common in coil procedures compared with device procedures. For PDAs ≤2.5 mm in diameter, institutional differences in preference for device versus coil exist.

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Section: Discussionmentioning

confidence: 99%

Safety of Percutaneous Patent Ductus Arteriosus Closure: An Unselected Multicenter Population Experience

El‐Said

Bratincsák

Foerster

et al. 2013

JAHA

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“…Surgical ligation or division is the primary option for PDA closure in a premature infant (<2 kg) with failed optimal medical treatment or in a patient with a very large PDA or unsuitable anatomy such as aneurysm formation [ 1 , 20 , 21 ]. This surgery is performed using a left posterolateral thoracotomy approach without cardiopulmonary bypass.…”

Section: Treatment Of Pda; Surgery Versus Interventionmentioning

confidence: 99%

The Patent Ductus Arteriosus in Adults with Special Focus on Role of CT

et al. 2021

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The primary imaging modality for the diagnosis of patent ductus arteriosus (PDA) is echocardiography. However, CT may be the technique on which an incidental PDA is first recognized because of the increasing number of chest CT scans performed for a variety of causes. Identification of PDA on CT may lead to earlier closure using a PDA occluder device. Immediate identification of incidental PDA is important, but a high rate of missed diagnosis of PDA has been reported due to its small size and anatomic location. In addition, echocardiography may overlook the presence of even a large PDA due to decrease in the amount of shunting through the PDA caused by high pulmonary artery pressures. This review provides the basic CT anatomy and clinical perspective of PDA, and discusses the role of CT in the evaluation of PDA as well as methods to avoid overlooking a small PDA on CT.

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“…Patent ductus arteriosus, a commonly seen congenital heart disease, accounts for 12%~15% of congenital heart disease; 10% of cases of patent ductus arteriosus also combine other heart malformations; large patent ductus arteriosus (diameter larger than 10 mm) is more likely to induce severe pulmonary arterial hypertension. 1 , 2 Nine patients included in this study suffered from large patent ductus arteriosus as well as multiple heart malformations and moderate or severe pulmonary arterial hypertension. Currently, the key of treatment for patent ductus arteriosus in combination with severe pulmonary arterial hypertension lies on the confirmation of reversibility of pulmonary arterial hypertension.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary artery closure in combination with patch technique for treating congenital heart disease combined with largepatent ductus arteriosus: A clinical study of 9 cases

et al. 2016

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Objective:To document clinical experience of treating congenital heart disease combined with large patent ductus arteriosus with pulmonary artery closure in combination with patch technique.Methods:Thirty-six patients (8 males and 28 females) who suffered from congenital heart disease and underwent hybrid surgery in the First Affiliated Hospital of Zhengzhou University from October 2010 to February 2014 were selected for this study. They aged 14 to 39 years and weighed 32.20 to 61.50 kg. Diameter of arterial duct was between 10 mm and 13 mm; 28 cases were tube type, 4 cases were funnel type and four cases were window type. All patients had moderate or severe pulmonary arterial hypertension; besides, there were 28 cases of ventricular septal defect, 16 cases of atrial septal defect, eight cases of aortic insufficiency, four cases of mitral stenosis and insufficiency and four cases of infectious endocarditis. Cardz Pulmonary Bypass (CPB) was established after chest was opened along the middle line. With the help of Transesophageal echocardiography, large patent ductus arteriosus was blocked off through pulmonary artery. Pulmonary artery was cut apart after blocking of heart. Large patent ductus arteriosus on the side of pulmonary artery was strengthened with autologous pericardial patch.Results:Of 36 patients, 32 patients had patent ductus arteriosus closure device and four patients had atrial septal defect closure device. Pulmonary arteries of 36 cases were all successfully closed. Systolic pressure declined after closure ((54.86±19.23) mmHg vs (96.05±23.07) mmHg, p<0.05); average pulmonary arterial pressure also declined after closure ((39.15±14.83) mmHg vs (72.88±15.76) mmHg, p<0.05). The patients were followed up for one to fifty one months (average 11.5 months). Compared to before surgery, left atrial diameter, left ventricular diameter and pulmonary artery diameter all narrowed after surgery. Besides, clinical symptoms were relieved and cardiac function of the patients also improved.Conclusion:Hybrid surgery is feasible and safe in treating patients with large patent ductus arteriosus and congenital heart disease, which decreases surgical problems, shortens surgical time and lowers the incidence of complications.

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The Role of Surgical Ligation of Patent Ductus Arteriosus in the Era of the Rashkind Device

Cited by 22 publications

References 19 publications

Safety of Percutaneous Patent Ductus Arteriosus Closure: An Unselected Multicenter Population Experience

Safety of Percutaneous Patent Ductus Arteriosus Closure: An Unselected Multicenter Population Experience

The Patent Ductus Arteriosus in Adults with Special Focus on Role of CT

Pulmonary artery closure in combination with patch technique for treating congenital heart disease combined with largepatent ductus arteriosus: A clinical study of 9 cases

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