BACKGROUND: This review is about the patency of ductus arteriosus (PDA), with particular care concerning diagnosis, surgical techniques, survival and postoperative pregnancy in operated females. METHODS: a) Sperimental study: the research has been conducted retrospectively and the follow-up is 40 years. b) ENVIRONMENT: all the patients were operated on in the Division of Cardiac Surgery, University of Turin (public structure) and in the Italian Institution of Cardiac Surgery (private structure). c) PATIENTS: from 1958 to 1987, 677 patients were operated on: mean age was 11.5 +/- 8.7 years. A complete follow-up was made on 487 patients (72%). d) Technique of operation: left lateral thoracotomy was often performed; in younger children, however, the tying of PDA was frequently made within the pericardium by left anterior thoracotomy in the third intercostal space. In uncomplicated situations, PDA was tied more frequently than divided, by two purse string stitches and one or two transfixed ligatures. e) SURVEY: overall early and late mortality, the clinical conditions of all patients, pregnancies and preor postoperative miscarriages of operated women were examined. RESULTS: From 1958 to 1967 overall early mortality was 5%; during the following years, there was no hospital mortality. The recurrence of PDA occurred only in 4 patients. 72% of the operated females became pregnant. CONCLUSION: Life expectancy is normal after surgical closure of an uncomplicated PDA in infancy or in childhood but premature death may not always be avoided operating on adults with long-standing chronic congestive heart failure. At least, postoperative pregnancy is not a risk factor for the mother and PDA seems not to be correlated to foetal transmission.

Adolescent↗

PubMedDate not supplied

[Surgery in heart defects. Interview granted to Minerva Medica by Prof. A. Actis Dato].

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Aortic Valve Insufficiency↗

PubMedDate not supplied

[Heart valve prosthesis, pregnancy and anticoagulant therapy].

The reproductive possibilities of cardiopathic patients with cardiac valvular prostheses have greatly improved in the past forty years. The correct management of this risk pregnancies remains a problem, however, especially as regards the chronic anticoagulant treatment to which these patients are subjected. The thirty years experience of a heart surgery-obstetric team is reported here. This included 14 pregnancies in women with aortic or mitral valvular prostheses. The problems relating to anticoagulant treatment in pregnancy and during labour are discussed.

Adult↗

PubMedDate not supplied

[Surgical cardiopathies and pregnancy (a 30-year report)].

The advent of heart-surgery in obstetrics has been determinant, in as much as it has improved therapeutic treatment and above all it has resulted in achievement which were impossible 30 years ago. The concepts already put forward by the school of cardio-obstetric surgery of Turin on haemodynamics in pregnancy and childbirth as biologic risk factors for the patient with a bad heart continue to be upheld. The results of Actis Dato Group's in cardiac surgery are reported. Almost all types of congenital and acquired cardiopathies in their relationships to pregnancy are described. 1750 Pregnancy cases in 997 heart diseased women are analised. The cooperation with the obstetrical team is stressed.

Adolescent↗