• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1035-1037
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• 2009

Patent ductus arteriosus (PDA) is a common congenital heart defect. All PDAs, regardless of size or degree of symptoms, require occlusion. Transcatheter PDA occlusion features fewer complications than trans-thoracic closure. It is also more cost-effective and has an excellent occlusion rate. Therefore, transcatheter PDA occlusion is accepted as the standard treatment option for PDA. However, tubular-type PDAs are difficult to close with ordinary detachable coils or the Amplatzer Duct Occluder; thus, these lesions remain a challenge for transcatheter closure. We attempted to occlude a tubular-type PDA by using an oversized Amplatzer Vascular Plug, which allowed intraluminal packing of the ductus. By using this treatment method, PDA occlusion was achieved safely with an excellent final outcome. We suggest that this approach may be a good option for transcatheter closure of a tubular-type PDA.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.593-606
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• 1984

With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

• Journal of The Korean Radiological Technologist Association
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• v.25 no.1
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• pp.146.1-146.1
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• 1999

• Clinical and Experimental Pediatrics
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• v.61 no.2
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• pp.68-69
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• 2018

• Clinical and Experimental Pediatrics
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• v.62 no.11
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• pp.410-411
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• 2019

• Journal of Chest Surgery
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• v.32 no.1
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• pp.22-26
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• 1999

Background: Treatment of adult patent ductus arteriosus(PDA) has many difficulty such as pulmonary hypertension, arterial wall calcification, aneurysmal chage of ductus. We tried to evaluate the effect of surgical interruption of PDA on postopeative change of heart size. Material and Method : From 1987 to 1997 we experienced 30 cases of the ligation of patent ductus arteriosus in adult at the department of cardiovacular surgery in Masan Samsung General Hospital. Result: There were 9 males and 21 females and their ages ranged from 16 to 44 years, with a mean age of 26.1 years. 15 patients had pulmonary hypertension and 9 patients complained of dyspnea with a degree of functional NYHA class III. Operation method was double or triple ligation using Teflon felt. Postoperative complications were wound dehiscence in 3 patients and transient hoarseness in 1 patient. The mean preoperative cardiothoracic ratio was 54.7%, and mean postoperative cardiothoracic ratio was 51.9%. The change of cardiothoracic ratio was more typical in the cases who had congestive heart failure. Their mean preoperative cardiothoracic ratio was 64.8% and the mean postoperative cardiothoracic ratio was 58.5% there was no postoperative deaths. Conclusion: We canclude that the improvement in cardiothoracic ratio may result from surgical intervention of PDA.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.9-16
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• 1981

Twenty eight patients with conpnital heart disuse underwent lung biopsy to assets pulmonary obstructive vascular disease at cardiac surpry. Thirteen patients had patent ductus arteriosus, 10, ventricular septal defects and S, atrial septal defects. The aaes were between 2 and 30 years. In patients with patent ductus arteriosus lung biopsy was performed from the IIngular Hlment. The anterior seament of the right upper lobe was blopsled in cases with ventricular septal defect and atrial septal defect. Grading of pulmonary obstructive vascular disease could not be assessed In 9 cases. In 2 cases poor quality of the slides made us impossible to evaluate and In 7 cases there were no suitable small muscular arteries to evaluate in the slides of lung tissue especially taken from the IIngular seament. Nineteen cases were evaluated pulmonary obstructive vascular disease. Among them 17 cases had Heath-Edwards changes of grade 1 and 2 patients had that of grade 3. The thickness of media was measured. It was expressed as percentage of medial thickness to outer diameter of artery. The medial thickness was correlated proportionally with elevation of pulmonary arterial pressure and pulmonary vascular resistance to systemic vascular resistance ratio. There were no complications related to the procedure of lung biopsy.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.360-370
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• 1985

A case of complete interruption of aortic arch with aortopulmonary window, patent ductus arteriosus, and aberrantly originated right subclavian artery from proximal descending aorta, in a four year old boy is reported in detail. This is the only reported case in Korea, who has had a successful one-stage total anatomical correction of this combination of defects. Under deep hypothermia and total circulatory arrest, aortic continuity was established using patent ductus arteriosus and anterior wall of pulmonary artery, which was anastomosed obliquely to anteromedial side of ascending aorta. Aortopulmonary window was closed using Impra patch via pulmonary arteriotomy. Then pulmonary arteriotomy was reconstructed primarily except at the junction of right pulmonary artery and main pulmonary artery, where a small piece of pericardium was used to close the defect to prevent kinking and narrowing of right pulmonary artery. Postoperative cardiac catheterization demonstrated a good reconstruction.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.793-797
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• 1987

Coronary artery fistula is an uncommon congenital heart defect that is readily amenable to surgical treatment. This fistula usually originates from the right coronary artery, but may arise from the left coronary artery, both coronary arteries, or single coronary artery. And the fistulous communication is most often to right ventricle, right atrium or pulmonary artery. Recently we experienced one case of congenital coronary artery fistula which was associated with patent ductus arteriosus. The fistulous communication, forming aneurysmal dilatation, was noted between the left anterior descending coronary artery and the right ventricular outflow tract. Cardiopulmonary bypass was employed in this case. After an arteriotomy was made on the aneurysmal coronary artery, both the proximal opening and the termination site of the fistulous tract were directly closed with partial aneurysmorrhaphy. The right ventricular chamber was also opened to evaluate the fistulous termination site. Postoperative hospital course of the patient was uneventful and she was discharged without problems.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1139-1145
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• 1990

Seven infants less than age 3 months underwent patch aortoplasty and tube graft bypass for relief of coarctation of aorta. All had intractable congestive heart failure, despite aggressive medical therapy Each infant had other cardiac anomalies including patent ductus arteriosus, ventricular septal defect, atrial septal defect and congenital mitral stenosis. All patients underwent closure of the ductus arteriosus and patch angioplasty of the aorta to produce a luminal diameter of at least 15mm or tube graft interposition utilizing the Gortex tube graft diameter larger than 10mm. In 5 patients who had ventricular defect, they underwent pulmonary arterial banding. &ere was one hospital death 17 days after operation secondary to the hydronephrosis and renal failure. Hospitalization was less than 10 days after operation except one case. In 3 patients who had associated VSD, open heart surgery[VSD closure+PA debanding]was done without difficulty. Surgical repair of critical coarctation of the aorta in infants can safely be offered despite the poor preoperative condition and presence of other cardiac anomalies.