• Title/Summary/Keyword: patent ductus arteriosus

Search Result 250, Processing Time 0.029 seconds

Clinical Result of the Patent Ductus Arteriosus in the Premature Infants (미숙아 동맥관 개존증의 치료성적)

  • 김오곤;이석재;홍종면;홍장수;전용선;김공수;한헌석
    • Journal of Chest Surgery
    • /
    • v.32 no.1
    • /
    • pp.16-21
    • /
    • 1999
  • Background: This study is to suggest the optimal method as a treatment for the patent ductus arteriosus in the premature infants. Material and Method : Between April 1994 and April 1997, 45 premature infants with evidence of a hemodynamically significant patent ductus arteriosus associated with cardiopulmonary compromise underwent indomethacin therapy, surgical treatment, or both. Thirty-nine infants received indomethacin and twelve infants among them were surgically ligated because of indomethacin failure(5) or complications(7). Six infants, who weighed less than 1,500 gm at birth, were referred for primary surgical ligation because of contraindication to indomethacin therapy. Result: The failure rate of indomethacin therapy was 43%(17/39) and the complications(13/39, 33%) to the indomethacin were associated with a high morbidity and mortality. Among the infants who underwent ligation, there were no failures and complications related to the operation. This data suggests that in the premature neonate with a hemodynamically significant PDA, (1) indomethacin therapy is associated with a high failure rate and significant complications, (2) surgical duct closure is associated with minimal morbidity. Conclusion: Although the results of this study cannot suggest the optimal management for PDA in premature infants, primary surgical ligation may be considered. However, long-term studies will be needed to confirm this later.

  • PDF

Application of double ligation in 3 dogs with patent ductus arteriosus (동맥관 개존증을 보이는 개에서의 이중 결찰술 실시 3예)

  • Yoon, Hun-young;Kim, Jun-young;Han, Hyun-jung;Jang, Ha-young;Lee, Bo-ra;Namkung, Hyo-sun;Park, Hee-myung;Jeong, Soon-wuk
    • Korean Journal of Veterinary Research
    • /
    • v.46 no.2
    • /
    • pp.171-175
    • /
    • 2006
  • Three dogs with suspected patent ductus arteriosus were referred to Veterinary Medical Teaching Hospital of College of Veterinary Medicine, Konkuk University because of cough, shortness of breath, exercise intolerance, and syncope, Continuous murmur and thrill were detected in physical examination. Left ventricular enlargement, cardiomegaly, bulged main pulmonary artey were found in radiography. Tall R wave, wide P wave, atrial fibrillation, and turbulent flow were observed in electrocardiogram and echocardiogram. Thoracotomy was performed at left fourth intercostal space under isoflurane anesthesia. Patent ductus arteriosus was double ligated with 1-0 silk. The median (mean ${\pm}$ SD) diameter of patents was $8.0{\pm}2.0mm$. The median operation time was $36{\pm}6.6min$. On examination right after surgery, continuous murmur, thrill, atrial fibrillation, and turbulent flow were disappeared. On 30 days after surgery, clinical signs, left ventricular enlargement, and, bulged main pulmonary artery were disappeared. VHS 12.5 and 13.5, R wave 3.3 and 3.0 mV, and P wave 0.05 and 0.05 sec were decreased to 10.0 and 10.5, 1.8 and 2.0 mV, and 0.04 and 0.04 sec respectively in case 1 and 2. Ratio of aorta and main pulmonary artery in diameter was changed 1 : 1.3 and 1 : 1.6 into 1 : 1.1 and 1 : 1 respectively in case 1 and 2. Mild tear developed during dissection in case 3 and hemorrhage was controlled by vascular Devakey forceps. However, the dog died. On 12 months after surgery, patients (case 1 and case 2) have not showed abnormal signs.

The Clinical Analysis of Patent Ductus Arteriosus (동맥관개존증의 임상적 고찰)

  • 박상섭
    • Journal of Chest Surgery
    • /
    • v.21 no.3
    • /
    • pp.510-517
    • /
    • 1988
  • With the ligation of a patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease, and treatment of the patent ductus is representative of the rapid advance made in thoracic surgery in the last 40 years. We have had clinical experiences about 36 cases of this in the department of Thoracic & Cardiovascular surgery, Pusan Paik Hospital, Inje medical college from March 1891 to June 1987. And the results were summarized as follows. 1. There were 11 males, 25 females. The age range of the patients were from 8 months to 36 years with the mean age of 7.9 years. 2. The chief complaints of the patients on admission were frequent URI[50%], dyspnea on exertion[29.8%], chest pain[11.1% k 1%], growth retardation[2%], cough[2.8%], anorexia[2.8%]. But there were 11 patients[30.6%] having no subjective symptoms. 3. In auscultation, the usual continuous machinery murmur was noticed in 30 patients[83.3%], only systolic murmur in 6[16.7%]. 4. In the preoperative chest P-A views, there were noticed cardiomegaly in 20 cases, enlarged pulmonary conus and / or pulmonary plethora in 22 patients[61.1%]. 5. In the preoperative EGG findings, there were noticed pattern of LVH in 8 patients[22.2`], RVH in 2[5.6%], BVH in 4[11.5%] and normal in 19[52.89o]. 6. The size of PDA[mean] was 9.5 mm[length] and 8.8 mm[width], the range of length was from 4 to 29 mm and the range of width was from 4 to 18 mm. 7. There were noticed 6 cases which were combined with other anomalies[VSD in 2 cases, Coarctation of aorta in 2, Mitral regurgitation in 1, and AP window in 1]. 8. On operation, simple ligation of the ductus was performed in 30 cases[83.3%], division and suture-ligation in 5[13.9%]. 9. Postoperative complications were noticed in 4 cases[pneumonia in one case, wound infection or disruption in 3], but there were no mortality.

  • PDF

Treatment of PDA in Premature Newborns with Mefenamic Acid (Mefenamic acid를 이용한 미숙아 동맥관 개존증 치험)

  • Lee, Jae-Joon;Lee, Young-Hwan;Shin, Son-Moon
    • 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.

  • PDF

Genetic Screening of the Canine Transcription Factor AP-2 Beta(TFAP2B) Gene in Dogs with Patent Ductus Arteriosus(PDA) (동맥관 개존증(PDA)에 이환된 개에서의 전사 인자 AP-2 beta(TFAP2B) 유전자 스크리닝)

  • Nam, So-Jeong;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
    • /
    • v.26 no.2
    • /
    • pp.123-129
    • /
    • 2009
  • Patent ductus arteriosus(PDA) is an abnormal shunt between the descending aorta and pulmonary artery through the incompletely closed ductus arteriosus and is the most common congenital heart defect in dogs. Recent human genetic studies found that a the gene mutation in transcription factor AP-2 beta(TFAP2B) was responsible for syndromic cases of PDA. Mutations in the TFAP2B gene are associated with certain congenital cardiac defects in humans that include PDA. In this study, we isolated the entire coding exons of canine TFAP2B gene for genetic screening in dogs with PDA. Analysis of the deduced amino acid sequence suggested that the canine TFAP2B are phylogenetically closer to the human TFAP2B(100% identity in amino acid sequence) than mouse and rat. In cTFAP2B gene screening, one single c.936+203G>A base change was found in affected Maltese dogs with PDA. However, further screening found the same base change in one unaffected control dog, suggesting this base change might be polymorphism. No other base changes were found in other dog breeds enrolled in this study. Because the base change was located in the intronic region and found in an unaffected control dog, TFAP2B might not be responsible for familial PDA in Malteses and sporadic cases of other dog breeds, although the gene promoter region should be investigated before reaching to this conclusion. A future study that may take this study further would be to collect more samples and to screen TFAP2B in various breeds of dogs with PDA and other various congenital heart defects.

Transcatheter closure of small ductus arteriosus with amplatzer vascular plug

  • Cho, Eun Hyun;Song, Jinyoung;Kang, I-Seok;Huh, June;Lee, Sang Yoon;Choi, Eun Young;Kim, Soo Jin
    • Clinical and Experimental Pediatrics
    • /
    • v.56 no.9
    • /
    • pp.396-400
    • /
    • 2013
  • Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA) by using an Amplatzer vascular plug (AVP). Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared. Results: The mean age of the patients was $54.9{\pm}45.7$ months old. The PDAs were of type C (n=5), type D (n=12), and type E (n=3). The mean pulmonary end diameter of the PDA was $1.7{\pm}0.6$ mm, and the aortic end diameter was $3.6{\pm}1.4$ mm. The mean length was $7.3{\pm}1.8$ mm. We used 3 types of AVP devices: AVP I (n=5), AVP II (n=7), and AVP IV (n=8). The ratio of AVP size to the pulmonary end diameter was $3.37{\pm}1.64$, and AVP size/aortic end ratio was $1.72{\pm}0.97$. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P=0.002). The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter ($1.10{\pm}0.31$, P=0.032). Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.

Outcomes of transcatheter closure of ductus arteriosus in infants less than 6 months of age: a single-center experience

  • Choi, Gwang-Jun;Song, Jinyoung;Kim, Yi-Seul;Lee, Heirim;Huh, June;Kang, I-Seok
    • Clinical and Experimental Pediatrics
    • /
    • v.61 no.12
    • /
    • pp.397-402
    • /
    • 2018
  • Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed. Results: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was $3.3{\pm}1.5months$, and weight was $5.7{\pm}1.3kg$. The duct diameter at the narrowest point was $3.0{\pm}0.8mm$ as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01). Conclusion: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.

A case of anomalous origin of right pulmonary artery from the ascending aorta (상행대동맥에서 기시한 우폐동맥 수술치험 1)

  • Choe, Se-Yeong;Park, Lee-Tae;Yu, Yeong-Seon
    • Journal of Chest Surgery
    • /
    • v.17 no.4
    • /
    • pp.698-702
    • /
    • 1984
  • Anomalous origin of right pulmonary artery from ascending aorta is a rare congenital heart disease. We experienced a case of anomalous origin of right pulmonary artery from ascending aorta with associated patent ductus arteriosus and patent foramen ovale, which was diagnosed by angiocardiography and cardiac catheterization. The ductus was ligated just before bypass, and a Dacron-graft with a diameter of 16 mm was interpolated posteriorly to the aorta between the right pulmonary artery and the pulmonary trunk. The postoperative course was uneventful. The right heart catheterization and right ventriculography performed on postoperative twelfth day revealed widely patent anastomotic site between the right pulmonary artery and the pulmonary trunk without residual stenosis. She was discharged on postoperative fourteenth day.

  • PDF