[Certain difficulties of diagnosis and treatment of patent ductus arteriosus]

The diagnosis of patent arterial duct (PAD) is not felt to be difficult in the presence of systolic-diastolic murmur, and in 91.7% of cases it would be established on general clinical investigations. In 8.3% of cases the main ausculatatory sign of this defect was distorted or utterly absent. In such cases the correct diagnosis was somewhat difficult. The absence of systolic-diastolic murmur in patients with PAD with conditioned by pulmonary hypertension, insufficiency of pulmonary artery valves, mitral defect, a small diameter of the duct, aneurysm-like changes in the aorta and pulmonary artery, decreased elastic properties of the latter walls, as well. In the absence of PAD pathognomonic signs catheterization of heart cavities and aortography should be employed. Surgical therapy for the lesion concerned in complicated cases shows some specificity. Utilization of the posterolateral approach, controlled hypotension, provisional application of holders to the aorta and below the duct, its being ligated on synthetic pads made it possible to improve the results of treatment of the lesion involved.