Evaluation of the Growth of Central Pulmonary Arteries Following Patent Ductus Arteriosus Stenting in Patients with Duct Dependent Pulmonary Circulation

2020 ◽  
Vol 41 (8) ◽  
pp. 1667-1674
Author(s):  
Hala Elmarsafawy ◽  
Abdelfatah Elasfar ◽  
Fatma Aboalsoud Taha
Keyword(s):  
Patent Ductus Arteriosus ◽  
Pulmonary Circulation ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Patent Ductus

scholarly journals Patent Ductus Arteriosus Stenting for All Ductal-Dependent Cyanotic Infants

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
Kanishka Ratnayaka ◽  
Stephen J. Nageotte ◽  
John W. Moore ◽  
Peter W. Guyon ◽  
Krishna Bhandari ◽  
...  
Keyword(s):  
Blood Flow ◽  
Length Of Stay ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Practice Change ◽  
Almost All ◽  
Blalock Taussig Shunt ◽  
Patent Ductus

Background: Ductal-dependent cyanotic newborns require a secure source of pulmonary blood flow. There has been a recent migration to selective ductal (patent ductus arteriosus [PDA]) stenting for some of these children. Universal (nonselective) ductal stenting for all infants with ductal-dependent pulmonary blood flow is controversial. We examine outcomes from a single center with this practice change. Methods: We compare outcomes of all ductal-dependent pulmonary blood flow infants (2013–2020 [January–June]) in the following treatment eras: Era 1 (selective PDA stenting; 2013–2017) or Era 2 (universal PDA stenting; 2018–2020 [January–June]). Results: Eighty-eight patients (Blalock-Taussig shunt, n=41; PDA stent, n=47) met inclusion criteria. In Era 1, most received Blalock-Taussig shunt (62% [41/66]). In Era 2, all received PDA stents (100% [22/22]). There were more females in Era 2, but otherwise no demographic differences between eras. There were no differences in mortality, treatment failures, complications, or reinterventions between eras. Postprocedure length of stay was shorter in Era 2 (8 versus 22 days, P =0.02). There were less surgical revisions for PDA stent patients (2% versus 20%, P =0.02). Postprocedure recovery surrogate end points favored Era 2 and PDA stenting. Additional analysis revealed PDA stent (compared with Blalock-Taussig shunt) patients had shorter post-procedure (10 versus 29 days, P ≤0.001) length of stay and more symmetrical branch pulmonary arteries (0.9 versus 0.7, P =0.001) at subsequent surgery. Conclusions: PDA stenting for almost all ductal dependent cyanotic newborns can be safe and effective and may have lower morbidity than selective PDA stenting.

Interaction between pulmonary vasculature and the patent ductus arteriosus in very premature infants

2020 ◽  
pp. 1-3
Author(s):  
Julien I.E. Hoffman
Keyword(s):  
Patent Ductus Arteriosus ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Pulmonary Vasculature ◽  
Very Preterm Infants ◽  
Platelet Endothelial Cell Adhesion ◽  
Very Premature Infants ◽  
Patent Ductus

BACKGROUND: The benefits of closing the ductus arteriosus in very preterm infants have not been convincingly shown in numerous clinical trials. Because a large untreated ductus arteriosus can cause death from congestive heart failure in infants born at term, we need to explain why this might not occur in premature infants born at <28 weeks’ gestation. METHODS: Based on information in the literature, I have commented on the possible relationship between the pulmonary vasculature and the shunt through the patent ductus arteriosus. RESULTS: Many of these infants have bronchopulmonary dysplasia, in which animal and human studies have shown a reduced number of capillaries and small pulmonary arteries as well as reduction in vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1). Both of these import angiogenic factors. Some who do not have bronchopulmonary dysplasia may have a restricted pulmonary vascular bed. CONCLUSIONS: The increased pulmonary vascular resistance in very premature infants may restrict pulmonary blood flow even if the ductus is large, thus reducing the urgency for ductus closure.

ON THE POSSIBLE INFLUENCE OF GREAT ALTITUDES ON THE DETERMINATION OF CERTAIN CARDIOVASCULAR ANOMALIES

PEDIATRICS ◽  
1953 ◽  
Vol 12 (3) ◽  
pp. 259-262
Author(s):  
VICTOR ALZAMORA ◽  
ANDRÉS ROTTA ◽  
GUIDO BATTILANA ◽  
RICARDO ABUGATTAS ◽  
CARLOS RUBIO ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Circulation ◽  
Ductus Arteriosus ◽  
Place Of Birth ◽  
Lower Oxygen ◽  
Mechanical Factors ◽  
Cardiovascular Anomalies ◽  
Patent Ductus

Over a period of 8 years, 176 cases of cardiac anomalies have been found in over 10,000 consecutive admissions. The place of birth and its altitude have been recorded for each one of these causes. Patent ductus arteriosus and persistent interatrial communications are more likely to be found in patients born at high altitudes. It is suggested, but remains to be shown, that this is true for defects of the pulmonary artery. No apparent relation could be found in this series for other malformations. It is presumed that mechanical factors tied to the pulmonary circulation and the lower oxygen tension both have a decisive influence.

Surgical management of iatrogenic occluded left pulmonary artery

2018 ◽  
Vol 27 (5) ◽  
pp. 396-399
Author(s):  
Ali Sadeghpour Tabaie ◽  
Mohaddeseh Behjati ◽  
Hojjat Mortezaeian ◽  
Hamid Reza Pouraliakbar ◽  
Behshid Ghadrdoost ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Computed Tomography Angiography ◽  
Ductus Arteriosus ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Artery Occlusion ◽  
Patent Ductus

A 4-year-old boy developed dyspnea 18 months after attempted surgical patent ductus arteriosus closure using a clip that was inadvertently placed on the left pulmonary artery, followed by reoperation to repair the left pulmonary artery with a patch and re-close the ductus. Computed tomography angiography confirmed a large patent ductus arteriosus, left pulmonary artery occlusion, and patent left pulmonary veins. Therefore, a third surgery was performed for suture closure of the ductus and left pulmonary artery repair with an interposition tube graft. Follow-up by transthoracic echocardiography and computed tomography angiography showed good flow in the left and right pulmonary arteries.

Sign in / Sign up

Export Citation Format

Share Document