Is Surgical Ligation of Patent Ductus Arteriosus Necessary: The Western Australian Experience of Conservative Management

Objective: To determine different treatment options in patients of Patent Ductus Arteriosus with pulmonary hypertension beyond neonatal period. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was carried out in Pediatric Cardiology department of Rawalpindi Institute of Cardiology, from Jan 2017 to Jan 2019. Methodology: Patients having PDA with pulmonary hypertension were included in the study. Treatment options were divided into percutaneous catheter device closure, surgical ligation of patent ductus arteriosus and palliative treatment. Any adverse event during the procedure was documented. Stratification was done in regard to gender and age group. Post stratification chi square test was applied and p-value less than or equal to 0.05 was considered as significant. Results: Total number of patients included in the study were 37. Mean age (years) of patients (Mean ± SD) was 19.21 ± 8.76. Mean ± SD pulmonary artery pressure was 56.43 ± 11.55 mmHg. Percutaneous catheter device closure was successful in 24 (64.9%) patients, in 7 (18.9%) patients primary surgical PDA ligation was done, 3 (8.1%) patients were advised palliative treatment and in 3 (8.1%) patients adverse events occurred during percutaneous device closure and were thus referred for surgical ligation. Patent ductus Arteriosus Occlutech device was used in 18 (48.6%) patients, Occlutech VSD device was used in 7 (18.5%) patients and in 1 (2.7%) patient AGA duct occluder was used. Conclusion: In patients with patent ductus arteriosus and pulmonary artery hypertension, percutaneous catheter device closure is a safe and effective procedure.

Download Full-text

Severe Hemolysis after Implantation of a Rashkind Occluder in a Large Ductus

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239700500114 ◽

1997 ◽

Vol 5 (1) ◽

pp. 56-58

Author(s):

Jonathan KS Ho ◽

Anthony PC Yim ◽

Janet FY Lee ◽

Lawrence KK Tse ◽

Gary YK Mak ◽

...

Keyword(s):

Young Adult ◽

Patent Ductus Arteriosus ◽

Adult Female ◽

Conservative Management ◽

Unusual Case ◽

Ductus Arteriosus ◽

Patent Ductus

We report an unusual case of severe mechanical hemolysis after implantation of a 17-mm Rashkind patent ductus arteriosus occluder in a young adult female with a large ductus. The device failed with conservative management, including implantation of a second occluder, and surgery was required to close the ductus. This occluder may not be suitable for closure of a large patent ductus arteriosus.

Download Full-text

Efficiency and Safety of Patent Ductus Arteriosus Surgical Ligation in Extremely Low Birth Weight Infants Without Chest Tube Placement

Journal of Pediatric Intensive Care ◽

10.1055/s-0041-1731786 ◽

2021 ◽

Author(s):

Georgios Kourelis ◽

Meletios Kanakis ◽

Constantinos Loukas ◽

Felicia Kakava ◽

Konstantinos Kyriakoulis ◽

...

Keyword(s):

Birth Weight ◽

Patent Ductus Arteriosus ◽

Chest Tube ◽

Ductus Arteriosus ◽

Extremely Low Birth Weight ◽

Tube Placement ◽

Chest Tube Placement ◽

Surgical Ligation ◽

Patent Ductus

AbstractPatent ductus arteriosus (PDA) has been associated with increased morbidity and mortality in preterm infants. Surgical ligation (SL) is generally performed in symptomatic infants when medical management is contraindicated or has failed. We retrospectively reviewed our institution's experience in surgical management of PDA for extremely low birth weight (ELBW) infants without chest tube placement assessing its efficiency and safety. We evaluated 17 consecutive ELBW infants undergoing SL for symptomatic PDA (January 2012–January 2018) with subsequent follow-up for 6 months postdischarge. Patients consisted of 9 (53%) females and 8 (47%) males. Mean gestational age (GA) at birth was 27.9 ± 2.1 weeks. Median values for surgical age (SA) from birth to operation was 10 days (interquartile range [IQR]: 8–12); PDA diameter 3.4 mm (IQR: 3.2–3.5); surgical weight (SW) 750 g (IQR: 680–850); and days of mechanical ventilation (DMV) as estimated by Kaplan–Meier curve 22 days (95% confidence interval: 14.2–29.8). We observed a statistically significant negative association between DMV and GA at birth (rho = − 0.587, p = 0.017), SA (rho = − 0.629, p = 0.009) and SW (rho = − 0.737, p = 0.001). One patient experienced left laryngeal nerve palsy confirmed by laryngoscopy. Otherwise, there were no adverse events to include surgical-related mortality, recurrence of PDA, or need for chest tube placement during follow-up. SL of PDA in ELBW infants without chest tube placement is both efficient and safe. Universal consensus recommendations for the management of PDA in ELBW neonates are needed. Further study is required regarding the use of the less invasive option of percutaneous PDA closure in ELBW infants.

Download Full-text

Anesthetic management for the correction of a patent ductus arteriosus by means of either surgical ligation or transarterial occlusion in dogs Anesthesie voor de correctie van een persisterende ductus arteriosus via chirurgie of transarteriële occlusie bi

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v81i1.18373 ◽

2012 ◽

Vol 81 (1) ◽

pp. 17-23

Author(s):

M. Gozalo-Marcilla ◽

C. J. Seymour ◽

S. Schauvliege ◽

T. Bosmans ◽

F. Gasthuys

Keyword(s):

Veterinary Medicine ◽

Case Report ◽

Patent Ductus Arteriosus ◽

Anesthetic Management ◽

Ductus Arteriosus ◽

The Other ◽

Corrective Surgery ◽

Vascular Abnormalities ◽

Surgical Ligation ◽

Patent Ductus

Patent ductus arteriosus (PDA) is one of the most common congenital vascular abnormalities in the dog. In veterinary medicine, surgical ligation (SL) and transarterial occlusion (TO) are two possible treatments that require general anesthesia. Two 4-month-old dogs were anesthetized for the correction of PDA, one by SL and the other by TO. Two different anesthetic and analgesic protocols were used, and were chosen to avoid potential complications. This case report describes two possible anesthetic approaches for PDA corrective surgery (SL and TO).

Download Full-text