• Journal of Veterinary Clinics
• /
• v.27 no.6
• /
• pp.740-745
• /
• 2010

Patent ductus arteiosus (PDA) is the persistent opening of ductus arterious located between pulmonary artery and descending aorta after birth. Although PDA can be occluded by surgical ligation, interventional closure of PDA using various devices is being rapidly replaced to surgical ligation, because of its non-invasive nature of treatment and minimal post-care after treatment. Main problem encountering in interventional treatment in toy breed dogs is vascular inaccessibility due to small size of artery. Although transvenous approach using jugular veins has been developed, this technique requires experienced skill to locate occlude devices into PDA and has high risk of accidental dislodgement of occluding devices (i.e. embolization coils or vascular plugs). Therefore, in this study, we developed a modified technique for coil embolization using mini-angiocatheter with trans-femoral approach in toy breed dogs (< 3.0 kg of body weight). With this modified method, we were successfully treated two toy breed (Maltese) dogs with the left to right shunted PDA.

• Clinical and Experimental Pediatrics
• /
• v.50 no.6
• /
• pp.536-542
• /
• 2007

Purpose : We investigated the effects of restricted fluid in the first 7 days of life on the risk of bronchopulmonary dysplasia (BPD) or patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants. Methods : Eighty three VLBW infants who lived more than 28 days were selected. The amount of daily maintenance fluid was determined by calculation of insensible water loss (IWL) and urine output (UO). Seventy to 80 percent of calculated amount was given to the ventilated infants. Subjects were grouped into low (<25th%), moderate (25-75th%), and high (>75th%) fluid groups for the first 24 hours, 3 days and 7 days. Chi square tests analyzed proportions of subjects with or without morbidities across fluid groups. Multivariate logistic regression was used to analyze the effect of fluid intake on BPD or PDA, controlling for factors that are significantly associated with BPD or PDA by univariate analysis. Results : Rates of BPD and PDA were not significantly associated with fluid groups on each time period. The result was the same after controlling for factors that are significantly associated with BPD or PDA by univariate analysis. For the first 3 and 7 days, fluid intakes were positively related with maximal weight loss, urine output and mechanical ventilation duration. Conclusion : In VLBW infants, when given based on needs reflected from IWL and UO versus intake, relatively low fluid intakes in the first week of life do not decrease the risk of BPD or PDA, and vice versa. We suggest that calculation of daily fluid based on IWL and UO is appropriate for VLBW infants.

• Journal of the korean veterinary medical association
• /
• v.50 no.5
• /
• pp.302-306
• /
• 2014

• Journal of Chest Surgery
• /
• v.28 no.11
• /
• pp.989-993
• /
• 1995

Patent ductus arteriosus in adult is frequently complicated with aneurysm, calcification and pulmonary hypertension. Therefore, surgical treatment of patent ductus arteriosus in adult has some differences from that of infants and children. We have experienced 25 cases of adult patent ductus arteriosus from July 1983 to December 1994. Mean age of the patients was 26.6 years[16-59 years . There were 12 males and 13 females. Exertional dyspnea was the most frequent clinical manifestation. Pulmonary hypertension was present in eight patients. Ligation was done in 20 cases and surgery using cardiopulmonary bypass was done in 5 cases. There was one hospital death, which had a 5x5cm sized main pulmonary artery aneurysm and was operated under cardiopulmonary bypass. Recanalization occured in one patient who received Teflon-felt supported ligation. Although one case of recannalization after ligation was present, we believed the fact that ligation was safe and simple method of operation in adult patent ductus arteriosus without calcification and aneurysm.

• Journal of Veterinary Clinics
• /
• v.28 no.6
• /
• pp.591-594
• /
• 2011

A 9-month-old, intact female Maltese dog and one-year-old, intact female beagle dog were presented with continuous heart murmur. These 2 dogs were diagnosed as patent ductus arteriosus (PDA) based on the two-dimensional echocardiography and angiography. Due to the large shunt size, commercially available ductal occlude device was used for transcatheter occlusion of PDA. After Amplatzer$^{(R)}$ vascular plug placement, cardiac murmur was abruptly disappeared in Maltese dog and mildly decreased in beagle dog. Complications and safety after the procedure were evaluated regularly in these 2 dogs. This is first clinical application of Amplatzer$^{(R)}$ vascular plug for transcatheter closure of PDA in two dogs in Korea.

• Journal of Chest Surgery
• /
• v.30 no.6
• /
• pp.585-590
• /
• 1997

Between December 1994 and October 1996, 57 premature infants with evidence of a hemodynamically significant PDA associated with cardiopulmonary compromise underwent indomethcin therapy(Group I, n=48) or surgical ligation(Group II, n=9) because of indomethacin failure. The gestational alee(29.6$\pm$ 3.1weeks vs. 28.1 $\pm$ 1.6weeks) and birth weight(1,413 $\pm$ 580gm, ,098 $\pm$ 235gm) showed no significant differences between the two groups. Medical management included fluid restriction, diuretics, and indomethacin therapy(one or two cycles). Surgical libation was done at the neonatal intensive care unit(NICU) without moving the patient to the operation room. There was no complication associated with the operation. There were 9 deaths in Group I(19%, 9/48) and 2 deaths in Group II(22% , 219). The main causes of deaths were persistent bronchopulmonary dysplasia with sepsis(n=8) and intrapulmonary hemorrhage(n=3). The rate of medical treatment failure including death and complication in premature infants whose body weights were less than 1500gm was higher(41%, 15/38) than in premature infants whose body weights were more than 1500gm(16%, 3/19). Early surgical ligation of PDA may be applicable in the premature infant with a large size, low birth weight(<1500 gm), or associated intracardiac anomalies. Perfoming the operation in the NICU may be safe in s ead of moving the patient to the operating room.

• Journal of Veterinary Clinics
• /
• v.29 no.6
• /
• pp.498-501
• /
• 2012

A 10-month-old intact male Maltese dog (body weight, 1.6 kg) presented with intermittent cough and abnormal heart sounds. The dog was diagnosed with a left-to-right patent ductus arteriosus (PDA) on the basis of the results of transthoracic echocardiography, color flow Doppler examination, and angiography. Transcatheter occlusion of the PDA was performed using the $Amplatz^{(R)}$ Canine Duct Occluder (ACDO) via the femoral artery. The device was placed under fluoroscopic guidance and successfully occluded the PDA. The continuous heart murmur disappeared immediately after the correction and no residual flow was detected. The dog was discharged the following day and regularly examined for complications and safety. This is the first report demonstrating the clinical application of ACDO for the transcatheter closure of PDA via the femoral artery in a small-breed dog in Korea.

• Journal of Chest Surgery
• /
• v.31 no.3
• /
• pp.311-314
• /
• 1998

Of several techniques for closure of the patent ductus arteriosus, the less invasive surgical ranscatheter closure without thoracotomy(the Porstmann's procedure) may have a place between the Rashkind procedure and thoracotomy. We describe here a 68 year old woman with calcified patent ductus arteriosus which was successfully closed by the Porstmann's procedure.

• Clinical and Experimental Pediatrics
• /
• v.49 no.9
• /
• pp.959-965
• /
• 2006

Purpose : The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI). Methods : Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and control group(n=56), where prophylactic indomethacin were given within 6 hours after birth. Clinical outcomes were compared between these groups. Results : There were no significant differences in gestational age, birth weight, incidence of hemodynamically significant PDA and severe IVH, and mortality between prophylactic group and control group. However, there were more frequent indications for therapeutic indomethacin, higher incidence of intestinal perforation, and longer time to achieve full enteral feeding in prophylactic group than control group. The incidence of other adverse events attributed to indomethacin prophylaxis did not differ between two groups. Conclusions : Prophylactic indomethacin may not prevent hemodynamically significant PDA and severe IVH in ELBWI. On the contrary, it may be associated with increased risk of adverse events. Further efforts should be investigated to decrease PDA and severe IVH in ELBWI.

• Journal of Chest Surgery
• /
• v.29 no.11
• /
• pp.1270-1275
• /
• 1996

Pulmonary artery aneurysms are extremely rare conditions usually associated with congenital cardiac defects that cause increased pulmonary blood flow and pulmonary hypertension. The prognosis of pulmonary artery aneurysms is fatal due to the potential for rupture of the aneurysm and the underlying severe pulmonary hypertension. A 40-year old woman was admitted to our hospital with headache following traffic accident. On admission a continuous murmur was heard over the 2nd to 3rd intercostal space along left sternal border and a calcified cystic mass at left hilar portion was incidentally discoverd on chest reontgenogram. Cardiac catherization was diagnostic of a left to right shunt at main pulmoanry artery level and pulmonary hypertension. Pulmonary angiogram demonstrated a large aneurysm of main pulmonary artery extending into proximal left pulmonary artery. The pulmonary artery aneurysm associated with patent ductus arteriosus was diagnosed definitively and the patient was underwent resection of pulmonary artery aneurysm, closure of PDA and Dacron prosthetic graft replacement under cardiopulmonary bypass. The postoperative course was uneventful and the patient was discharged without any problem.