Patent Ductus Arteriosus Device or Surgical Closure: the Role of Charity Missions Where the Resources Are Limited

Abstract Objectives To compare the different methods of treatment of patent ductus arteriosus (PDA), and evaluate the role of charity missions in availing the expensive devices for needy patients where the resources are limited. Background The role of surgery is gradually being taken over by catheter intervention, however the cost in not affordable to most of our patients. Charity organizations are helping limited resource countries by availing the devices. Methods All paediatrics patent ductus arteriosus (PDA) patients presenting to Medani Heart Centre (MHC) in a 6-year period were included in this study. The study included 337 patients. 283 were treated by catheter intervention group (A) and 54 were treated surgically group (B), 22 patients were referred for surgery from the catheterization laboratory, and 32 were treated when there was no visiting teams. Results A total of 337 patients were included in this study, 32 were treated surgically by the local surgical teams. Out of remaining 305 patients 283 were found suitable for catheterization intervention, and were treated successfully, 22(%7) were having other congenital anomalies or PDA not suitable for intervention and were referred to surgery. 54 patients were treated by surgical ligation, 22 were referred from the intervention group and 32 were treated surgically when there were no visiting delegates and patients’ condition dictate urgent intervention, with good results. Devices were provided by charity organizations and delivered by the visiting teams, the choice of device depends on the availability. Conclusions Surgery remains a good modality of treatment were the resources are scares, however a number of charity organizations are offering these expensive devices for countries of low and middle income making it possible for the poor patients to have such treatment. The results of both treatments are excellent

Download Full-text

Patent Ductus Arteriosus Device or Surgical Closure: the Role of Charity Missions Where the Resources Are Limited

10.21203/rs.3.rs-959615/v2 ◽

2021 ◽

Author(s):

Abdallah Elamin Elsheikh ◽

Salah Eldin M.E.HASSAN ◽

Abdal Mahmoud El Siddig ◽

Mohamed Elamin Ahmed ◽

Sabir Taha Hussein ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Intervention Group ◽

Limited Resource ◽

Catheter Intervention ◽

Middle Income ◽

Catheterization Laboratory ◽

Surgical Closure ◽

Patent Ductus

Abstract Objectives: To compare the different methods of treatment of patent ductus arteriosus (PDA), and evaluate the role of charity missions in availing the expensive devices for needy patients where the resources are limited.Background: The role of surgery is gradually being taken over by catheter intervention, however the cost in not affordable to most of our patients. Charity organizations are helping limited resource countries by availing the devices.Methods: All paediatrics patent ductus arteriosus (PDA) patients presenting to Medani Heart Centre (MHC) in a 6-year period were included in this study. The study included 337 patients. 283 were treated by catheter intervention group (A) and 54 were treated surgically group (B), 22 patients were referred for surgery from the catheterization laboratory, and 32 were treated when there was no visiting teams.Results: A total of 337 patients were included in this study, 32 were treated surgically by the local surgical teams. Out of remaining 305 patients 283 were found suitable for catheterization intervention, and were treated successfully, 22(%7) were having other congenital anomalies or PDA not suitable for intervention and were referred to surgery. 54 patients were treated by surgical ligation, 22 were referred from the intervention group and 32 were treated surgically when there were no visiting delegates and patients’ condition dictate urgent intervention, with good results. Devices were provided by charity organizations and delivered by the visiting teams, the choice of device depends on the availability.Conclusions: Surgery remains a good modality of treatment were the resources are scares, however a number of charity organizations are offering these expensive devices for countries of low and middle income making it possible for the poor patients to have such treatment. The results of both treatments are excellent

Download Full-text

Adult patent Ductus Arteriosus complicated by endocarditis and hemolytic anemia

Colombia Medica ◽

10.25100/cm.v46i2.1857 ◽

2015 ◽

pp. 80-83 ◽

Cited By ~ 1

Author(s):

Feridoun Sabzi ◽

Reza Faraji

Keyword(s):

Patent Ductus Arteriosus ◽

Hemolytic Anemia ◽

Ductus Arteriosus ◽

Peripheral Blood Smear ◽

Rare Presentation ◽

Surgical Closure ◽

Reactive Protein ◽

Patent Ductus

An adult with a large patent ductus arteriosus may present with fatigue, dyspnea or palpitations or in rare presentation with endocarditis. The case illustrated unique role of vegetation of endocarditis in hemolytic anemia in adult with patent ductus arteriosus (PDA). Despite treatment of endocarditis with complete course of appropriate antibiotic therapy and normality of C- reactive protein, erythrocyte sedimentation rate and leukocytosis and wellness of general condition, transthoracic echocardiography revealed large vegetation in PDA lumen, surgical closure of PDA completely relieved hemolysis, and fragmented red cell disappeared from peripheral blood smear. The 3-month follow-up revealed complete occlusion of PDA and abolishment of hemolytic anemia confirmed by clinical and laboratory examination.

Download Full-text

Ligation of left pulmonary artery instead of patent ductus arteriosus

Cardiology in the Young ◽

10.1017/s1047951120002784 ◽

2020 ◽

Vol 30 (12) ◽

pp. 1943-1945

Author(s):

Semih Murat Yucel ◽

Irfan Oguz Sahin

Keyword(s):

Surgical Treatment ◽

Pulmonary Artery ◽

Patent Ductus Arteriosus ◽

Surgical Complication ◽

Ductus Arteriosus ◽

Left Pulmonary Artery ◽

Artery Ligation ◽

Surgical Closure ◽

Post Operative Period ◽

Patent Ductus

AbstractDuctus arteriosus is an essential component of fetal circulation. Due to occurring changes in the cardiopulmonary system physiology after birth, ductus arteriosus closes. Patent ductus arteriosus can be closed by medical or invasive (percutaneous or surgical) treatment methods. Percutaneous or surgical closure of patent ductus arteriosus can be performed for the cases that medical closure failed. Surgical treatment is often preferred method for closure of patent ductus arteriosus in the neonatal period. The most common surgical complications are pneumothorax, recurrent laryngeal nerve injury, bleeding, and recanalisation. A very rare surgical complication is left pulmonary artery ligation that has been presented in a few cases in the literature. Echocardiography control should be performed in the early post-operative period, especially in patients with clinical suspicion. If reoperation is required, it should never be delayed. We report a newborn patient whose left pulmonary artery ligated accidentally during patent ductus arteriosus closure surgery and surgical correction of this complication at the early post-operative period.

Download Full-text

SURGICAL CLOSURE OF ATYPICAL PATENT DUCTUS ARTERIOSUS

Journal of Thoracic Surgery ◽

10.1016/s0096-5588(20)30930-2 ◽

1956 ◽

Vol 31 (3) ◽

pp. 332-337

Author(s):

N.A. Antonius ◽

L.G. Massarelli ◽

A.D. Crecca

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Surgical Closure ◽

Patent Ductus

Download Full-text

Low-Dose Intravenous Paracetamol for Patent Ductus Arteriosus in Indomethacin-Resistant or Contraindicated Preterm Infants: Three Cases Reports

American Journal of Perinatology Reports ◽

10.1055/s-0037-1615260 ◽

2017 ◽

Vol 07 (04) ◽

pp. e230-e233 ◽

Cited By ~ 1

Author(s):

Shun Matsumura ◽

Ayumi Oshima ◽

Sumie Fujinuma ◽

Kosuke Tanaka ◽

Nobuhiko Nagano ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Premature Infants ◽

Ductus Arteriosus ◽

Limited Data ◽

Gastrointestinal Complications ◽

Surgical Closure ◽

Institutional Ethics ◽

Intravenous Paracetamol ◽

Administration Protocol ◽

Patent Ductus

Background Although indomethacin (IND) is the standard treatment for hemodynamically significant patent ductus arteriosus (hsPDA) in Japan, it may be associated with renal impairment and gastrointestinal complications. The use of paracetamol for hsPDA closure has recently increased. Unlike IND, paracetamol does not have a peripheral vasoconstrictive effect and can be given to infants with contraindications to IND. Based on limited data available from randomized trials, paracetamol and IND seem to have similar effects. However, there have been no reports of the use of paracetamol for hsPDA in Japan. Cases Our drug administration protocol was approved by the institutional ethics committee after purchasing a clinical trial insurance. In three premature infants in whom IND was contraindicated or ineffective, a 7.5 mg/kg of paracetamol was intravenously administered every 6 hour for 3 days after obtaining parental consents. A temporary hsPDA closure was observed in two of the three infants. However, all three infants eventually needed surgical closure. No side effects, such as hepatic and renal dysfunctions, and adverse events were reported. Conclusion The intravenous administration of paracetamol was safe and feasible in premature infants with hsPDA. Future clinical trials with optimized dose and timing of administration are needed.

Download Full-text

STUDIES OF THE PULMONARY AND SYSTEMIC ARTERIAL PRESSURE IN CASES OF PATENT DUCTUS ARTERIOSUS WITH SPECIAL REFERENCE TO EFFECTS OF SURGICAL CLOSURE 1

Journal of Clinical Investigation ◽

10.1172/jci102312 ◽

1950 ◽

Vol 29 (6) ◽

pp. 745-753 ◽

Cited By ~ 14

Author(s):

Bowen E. Taylor ◽

Albert A. Pollack ◽

Howard B. Burchell ◽

O. Theron Clagett ◽

Earl H. Wood

Keyword(s):

Arterial Pressure ◽

Patent Ductus Arteriosus ◽

Special Reference ◽

Ductus Arteriosus ◽

Systemic Arterial Pressure ◽

Surgical Closure ◽

Patent Ductus

Download Full-text

Comparison of the effect of two drugs paracetamol with intravenous ibuprofen in patent ductus arteriosus treatment

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20201741 ◽

2020 ◽

Vol 9 (5) ◽

pp. 690

Author(s):

Mehrdad Mirzarahimi ◽

Ramin Emamzadeghan ◽

Afsaneh Enteshari Moghaddam ◽

Narges Falsafi

Keyword(s):

Patent Ductus Arteriosus ◽

Ductus Arteriosus ◽

Alternative Therapy ◽

Cyclooxygenase Inhibitors ◽

Arterial Duct ◽

Intravenous Paracetamol ◽

Liver Parameters ◽

Intravenous Ibuprofen ◽

Patent Ductus

Background: Patent ductus arteriosus (PDA) is a common cause of morbidity and mortality among premature infants that affects more than 40% of them. PDA treatment includes medical and surgical treatment. Most drugs used to block PDA are cyclooxygenase inhibitors (ibuprofen and indomethacin). The role of paracetamol as an alternative therapy in PDA ligation has been considered in recent years due to the potential side effects of cyclooxygenase inhibitors.Methods: Patients in the first group were treated with intravenous paracetamol at a dose of 15 mg/kg every 6 hours for three days and the second group was treated with intravenous ibuprofen at a daily dose of 10 mg/kg daily and 5 mg/kg for the second and third days. At the end of the treatment period (day 3), they underwent echocardiography again. If the echocardiographic findings indicated no closure of the arterial duct, patients were treated with the aforementioned drug for another period and rechecked at the end of the third day, and at each stage required information was collected.Results: Arterial duct closure in paracetamol group was 96.7% and in ibuprofen group was 100%. The effects of both paracetamol and ibuprofen were similar in terms of renal parameters but in terms of effects on liver parameters. The effect of paracetamol on all liver parameters except aspartate transaminase (AST) was significant, but ibuprofen was able to affect only bilirubin among liver parameters and had no significant effect on both AST and alanine aminotransferase, parameters.Conclusions: Results showed that both paracetamol and ibuprofen are effective in treating of PDA and had similar impact.

Download Full-text

Device closure of patent ductus arteriosus: analysis of cases in a Bangladeshi centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202573 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1481

Author(s):

Nurun N. Fatema ◽

Abul K. M. Razzaque

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Age Groups ◽

Device Closure ◽

Catheterization Laboratory ◽

Congenital Rubella ◽

First Choice ◽

Associated Conditions ◽

Patent Ductus

Background: Transcatheter closure of Patent ductus arteriosus (PDA) has become the first-choice therapy for closure in patients of any age group. Authors reviewed the outcome of device closure in all age groups starting from neonate to adult.Methods: From December 2014 to December 2019, 440 cases underwent transcatheter closure in a catheterization laboratory of a tertiary level cardiac hospital. Selection criteria were isolated PDA or PDA with associated conditions which can be managed in the same setting by an intervention. Exclusion criteria were proven Eisenmenger syndrome. A retrospective review of outcome and complications were recorded from computerized data records.Results: Age of the patient varied from 10 days to 65 years. The median age was 3 years. Most of the patients were female (63%), weight varied from 1.8 kg to 75 kg. the median weight was 7.5 kg. Isolated PDA cases were 74.77 %. Among syndromes, congenital rubella syndrome was common (7.5%), followed by Down Syndrome (6.36%). The narrowest PDA diameter varied for 1.8 mm - 14 mm with a median of 5 mm. Among duct occluders, 8x6 mm CeraTM was the commonest one used in the study population. Complete occlusion was observed in 99.55% of cases.Conclusions: Transcatheter closure of PDA is considered safe and efficacious in all age groups. It is the gold standard now and replaced surgical option in most of the places.

Download Full-text