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Surgical Treatment for Patent Ductus Arteriosus: Our Experience of 12 Years
Mehmet Tort1, Münacettin Ceviz1, Fehimcan Sevil2
1Cardiovascular Surgery, Ataturk University School of Medicine, Erzurum, TUR.
Insights
Surgically closing patent ductus arteriosus (PDA) is essential for preventing severe cardiac and pulmonary complications. Surgical intervention effectively reduces pulmonary artery pressure, particularly in isolated PDA cases.
Area of Science:
- Cardiology
- Pediatric Surgery
- Congenital Heart Disease
Background:
- Patent ductus arteriosus (PDA) is a critical congenital heart defect.
- Untreated PDA can lead to pulmonary hypertension, heart failure, and mortality.
Purpose of the Study:
- To evaluate hemodynamic changes post-surgery in PDA patients.
- To assess surgical techniques and outcomes in PDA treatment.
- To compare early and late postoperative findings.
Main Methods:
- Retrospective analysis of 126 PDA patients undergoing surgical closure (2001-2012).
- Utilized echocardiography, angiography, and CT for diagnosis and follow-up.
- Compared outcomes between isolated PDA and PDA with congenital heart deformities.
Main Results:
- Pulmonary hypertension was prevalent (96.0%) preoperatively.
- Surgical closure significantly reduced pulmonary artery pressure in both isolated and complex PDA cases.
- Higher preoperative PAP and slower PAP reduction were observed in patients with congenital heart disease and right-left shunt.
Conclusions:
- Surgical PDA closure is vital for preventing cardiac and pulmonary sequelae.
- Surgical intervention effectively manages pulmonary hypertension associated with PDA.
- While surgical methods vary, closure is consistently effective in improving patient outcomes.
Abstract:
Introduction Patent ductus arteriosus (PDA) is a congenital heart disease that, if left untreated, can lead to pulmonary hypertension, congestive heart failure, and death. Here, we aimed to assess postoperative cardiac hemodynamic changes and surgical techniques, as well as early and late postoperative findings in surgically treated PDA patients. Materials and methods We retrospectively analyzed the data belonging to 126 patients whose PDA was surgically closed in our clinic from January 2001 to December 2012. With echocardiography being a standard in diagnosis and follow-up, angiography and computed tomography were also used in the presence of pulmonary hypertension and congenital heart disease, when needed. Postoperative data were compared between isolated PDA patients and those with congenital cardiac deformities. Results Evaluating the patients' pulmonary artery pressure (PAP), pulmonary hypertension was detected in 121 patients (96.0%). Preoperative PAP was significantly higher in PDA patients with congenital heart disease compared to the isolated PDA group (p<0.05). PAP decreased significantly in postoperative follow-up in both groups (p<0.05). However, this decrease was faster in the isolated PDA group than in patients with congenital heart disease and right-left shunt accompanying PDA (p<0.05). Regarding the correlation between ductus diameters and preoperative PAP, we found that as ductus diameter increased, PAP increased significantly (p<0.05). Conclusions In PDA patients, closing the ductus is necessary to prevent pulmonary and cardiac complications. Surgical closure remains one of the most effective methods for this, although there is little difference between surgical treatment methods in terms of mortality.
