Natural History of Pulmonary Hypertension in Surgically Treated Patent Ductus Arteriosus

<p>A 10 years old boy diagnosed as subaortic membrane with patent ductus arteriosus presented with history of occasional fever, repeated respiratory tract infection since childhood and poor gain weight.</p>

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MANAGEMENT OF HYPERTENSIVE PDA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v70isuppl-4.6003 ◽

2021 ◽

Vol 70 (Suppl-4) ◽

pp. S701-05

Author(s):

Khushal Khan Khattak ◽

Maad Ullah ◽

Abdul Malik Sheikh ◽

Asma Kanwal ◽

Sajid Ali Shah ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Patent Ductus Arteriosus ◽

Palliative Treatment ◽

Ductus Arteriosus ◽

Treatment Options ◽

Device Closure ◽

Surgical Ligation ◽

Percutaneous Catheter ◽

Patent Ductus

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.

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Elongated Patent Ductus Arteriosus with Intermittent Shunting

PEDIATRICS ◽

10.1542/peds.39.3.446 ◽

1967 ◽

Vol 39 (3) ◽

pp. 446-448

Author(s):

COLETTE M. KOHLER ◽

DAN G. MCNAMARA

Keyword(s):

Pulmonary Hypertension ◽

Case Report ◽

Patent Ductus Arteriosus ◽

Premature Infants ◽

Ductus Arteriosus ◽

Cardiac Defects ◽

Cardiac Catheterizations ◽

Delayed Closure ◽

Patent Ductus

The presence of patent ductus arteriosus without a typical continuous murmur has long been recognized, especially in the presence of pulmonary hypertension, or a small ductus, or with associated cardiac defects; however, there are only a few reports of documented, intermittently disappearing murmurs occurring in individuals over 6 months of age with a substantial shunt in the absence of pulmonary hypertension or associated defects. Danilowicz, et al. have recently reported delayed closure of the ductus anteriosus up to 6 months of age in some premature infants. We present this case report of a 2½-year-old boy with patent ductus arteriosus with cardiac catheterizations during the disappearance and subsequent reappearance of a continuous murmur with documentation of absence of shunting when the murmur was absent and substantial shunting if the murmur was present.

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