• Journal of Chest Surgery
• /
• v.40 no.12
• /
• pp.837-842
• /
• 2007

Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

• The Korean Journal of Nuclear Medicine
• /
• v.15 no.2
• /
• pp.75-79
• /
• 1981

A Case of main pulmonary artery aneurysm in a 9-year-old boy with patent ductus arteriosus is presented. In this case presented with a huge mass density on the chest X-ray, radionuclide cardiac angiography showed a vascular lesion, which was confirmed as an aneurysm of the main pulmonary artery at roentgenologic angiogram. The aneurysm appeared following an episode of bacterial endocarditis and pulmonary hypertension. A successful aneurysmectomy with multiple ligation of ductus arteriosus was performed.

• Journal of Veterinary Clinics
• /
• v.33 no.4
• /
• pp.221-224
• /
• 2016

An 8 month-old male Maltese (weighing 2.0 kg) was referred with loud heart murmur at routine physical exam in local animal clinic. Electrocardiogram found left ventricular hypertrophy pattern (4.5 mV R-wave). Diagnostic imaging studies revealed the elongation of left ventricle (LV) with classic triple bumps on the main pulmonary artery, aorta and left atrium on the ventrodorsal view of radiograph. Echocardiography revealed patent ductus arteriosus (PDA) duct and continuous turbulent shunt flow (maximal velocity 4.83 m/s) between the aorta and pulmonary artery with left to right direction. The PDA in this dog was successfully closed through femoral vein (transvenous approach) using a 5 mm Amplatz$^{(R)}$ Canine Duct Occluder. To the best of author's knowledge, this is the first case of PDA occlusion treated with Amplatz Canine Duct Occluder through femoral vein.

• Journal of Yeungnam Medical Science
• /
• v.10 no.2
• /
• pp.506-511
• /
• 1993

This study was conducted to examine the effect of mefenamic acid for treatment of PDA in premature newborns. Ductus arteriosus is reopened by locally produced prostaglandin $E_2$ in a premature newborn during hypoxia. Mefenamic acid is one of non-steroidal antiinflammatory drugs acting by inhibition of cyclo-oxygenase in the prostaglandin synthesis pathway. For three premature newborns with PDA, we administered mefenamic acid and evaluated them with echocardiography to study the effect of mefenmic acid for closure of PDA. In all three babies, ductus arteriosus was closed successfully. We feel that mefenamic acid is safe and effective medication for treatment of PDA in premature newborns, but further study need to be conducted with larger numbers of cases to confirm this effect.

• Journal of Veterinary Clinics
• /
• v.27 no.5
• /
• pp.573-578
• /
• 2010

A 4-year-old intact male Shih Tzu dog (weighing 5 kg), was presented with signs of severe dyspnea, exercise intolerance and cyanosis. Diagnostic studies suggested a reverse patent ductus arteriosus (rPDA) with pneumonia. Despite emergency treatments with oxygen, diuretics, antibiotics and medical therapy for hyperkalemia, the dog died of ventricular fibrillation from hyperkalemia and dehydration. Necropsy revealed the rPDA with a marked descending aortic dilation and abnormally arisen left common carotid artery.

• Journal of Chest Surgery
• /
• v.19 no.1
• /
• pp.43-49
• /
• 1986

At the Department of Thoracic and Cardiovascular Surgery, Hanyang university, from 1976 to 1984, 102 patients operated for isolated patent ductus arteriosus were studied. The correlation between the degree of left ventricular hypertrophy [LVH] and hemodynamic data, and postoperative changes of electrocardiographic findings were evaluated. The following results were obtained; [1] Of 102 patients with isolated patent ductus arteriosus, 78 patients [76.5%] were found to have LVH by EKG, preoperatively. [2] The patients with LVH had higher incidence of respiratory infection [79.4%] compared to patients without LVH. [3] Frequent physical findings in the patients with LVH were precordial bulging and P2 accentuation on auscultation. The typical continuous machinery murmur was not different in two group with or without LVH. [4] 66.1% of patients with LVH showed more than 56% of cardiothoracic ratio [CTR] on simple chest X-ray. 56.5% of patients without LVH showed less than 50% of CTR. [5] In the patients found to have LVH by EKG, the correlation between values of Svl+Rv6 and Qp/Qs in hemodynamic data was correlation coefficient 0.57 and between CTR and Qp/Qs was correlation coefficient 0.51. [6] In patent ductus arteriosus with LVH following surgery, the values of Svl+Rv6 was changed from preoperative 153.6$\pm$42.78% to 107.7$\pm$19.58% within 3 months and to 80.4$\pm$12.22%, which is within normal range of Svl+Rv6 on EKC, after 6 months.

• Journal of Veterinary Science
• /
• v.23 no.4
• /
• pp.39.1-39.5
• /
• 2022

Patent ductus arteriosus (PDA) is a rare congenital cardiovascular anomaly in cats. Due to their small body, intercostal thoracotomy is the most common option to close the PDA. However, few reports detail the surgical technique for ligating PDA in kittens. In this case report, three cats weighing 1.4 kg, 1.2 kg, and 2.9 kg were diagnosed PDA. Clip ligation via left fourth intercostal thoracotomy was performed and the cats were successfully treated. Postoperative echocardiography showed no residual flow in any of the cases. This case report highlights clip occlusion for small cats with PDA could be safe and effective.

• Korean Journal of Veterinary Research
• /
• v.64 no.2
• /
• pp.11.1-11.5
• /
• 2024

A 4-month-old intact male Sapsaree dog was referred due to a history of postprandial regurgitation following consumption of solid food. Thoracic radiography revealed focal leftward displacement of the thoracic trachea at T1 to T4 vertebrae levels. Barium contrast radiography revealed focal dilation of the cranial thoracic esophagus at the heart base level. Persistent right aortic arch (PRAA) with an aberrant left subclavian artery branching from the patent ductus arteriosus was diagnosed by computed tomography angiography (CTA). Although barium contrast radiography can presumptive diagnose PRAA, CTA should be considered for identifying additional vascular anomalies, specific types, and surgical planning.

• Journal of Chest Surgery
• /
• v.39 no.12 s.269
• /
• pp.957-959
• /
• 2006

Muscle sparing thoracotomy is known as alternative of posterolateral thoracotomy because of less postoperative pain, preservation of muscle power and better cosmetic outcome. Curved axillary thoracotomy(CAT) is a type of muscle sparing thoracotomy. Between July 2003 and August 2004, 5 patients diagnosed as pure patent ductus arteriosus(PDA) treated by CAT and we reviewed results retrospectively by clinical record. The operative procedures were ligation of ductus in 4 cases and division of ductus in 1 case. There were no postoperative complication. Curved axillary thoracotomy is considerable alternative for surgical treatment of PDA with merits of muscle sparing effect and cosmetic benefit.

• Journal of Chest Surgery
• /
• v.12 no.3
• /
• pp.233-239
• /
• 1979

Ventricular septal defect associated with patent ductus arteriosus is well known cardiac anomaly that can be treated successfully by operation. This anomaly is found at low frequency. Seven cases of the combined malformation were operated on during the period from 1959 to 1978 in the Department of Thoracic Surgery, Seoul National University Hospital. Right heart catheterization and retrograde aortogram can diagnose the disease correctly. Staged operation in one case and one-stage operation in 5 patients were done. In all cases of the open heart surgery the closure of the ductus was done by transpulmonary suture of the PDA opening. Among 6 patients of the open heart surgery 2 operative death [33.3%] and one late death [total 50%] were noted. Four type II and one type I and one Type IV VSDs were found. In one case the anomaly was accompanied with aortic insufficiency by herniation of the right coronary cusp through Type I VSD.