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Results for “DUCTUS ARTERIOSUS”

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At least 667 records · Page 37Linked to original sources

PubMed1991

Closure of the ductus arteriosus: determinant factor in the appearance of transient peripheral pulmonary stenosis of the neonate.

We speculated that a relationship may exist between transient peripheral pulmonary stenosis and the closure of the ductus arteriosus. Fifty preterm infants had pulmonary artery and ductal color Doppler flow velocity assessments performed before and after closure of the ductus arteriosus. No flow turbulence or increase in velocity was observed immediately after birth, although a significant discrepancy in size was observed between the main pulmonary artery and its two branches. After closure of the ductus, 15 infants had signs of transient peripheral pulmonary stenosis of the left pulmonary artery in association with a significant decrease of diameter at the origin of the same artery. In all 50 infants, no significant gradient was observed in the right pulmonary artery. We conclude that, at least in the preterm infant, transient peripheral pulmonary stenosis is not present at birth but is an acquired phenomenon closely related to closure of the ductus arteriosus.

Blood Flow Velocity↗

PubMed2002

A neonate with mitral stenosis due to accessory mitral valve, ventricular septal defect, and patent ductus arteriosus: changes in echocardiographical findings during the neonatal period.

A female neonate with mitral stenosis due to accessory mitral valve with ventricular septal defect and patent ductus arteriosus is described. She was referred to our hospital because of neonatal asphyxia. Asphyxia was improved by ventilator support, but rapid deterioration of respiration with pulmonary congestion and hemorrhage appeared 8 days after birth. Echocardiography revealed an accessory mitral valve attached to the anterior mitral leaflet with a perimembranous ventricular septal defect and patent ductus arteriosus. Although there were no echocardiographical findings indicating mitral stenosis on admission, the mitral stenosis blood flow patterns were detected by color and pulsed Doppler examination performed on the eighth day after admission. Transaortic resection of accessory mitral valve tissue was performed with patch closure of the ventricular septal defect and ligation of the ductus arteriosus 35 days after birth. After operation, pulmonary congestion and hemorrhage were improved. Postoperative echocardiography showed complete resection of the accessory mitral valve and no mitral insufficiency. We concluded that the combination of the accessory mitral valve and left-to-right shunt due to ventricular septal defect or patent ducturs arteriosus might have led to a critical hemodynamic condition due to relative mitral stenosis in the neonatal period with the decrease in pulmonary vascular resistance.

Cardiac Surgical Procedures↗

PubMed2004

[Failures and complications of transcatheter coil occlusion of patent ductus arteriosus].

An analysis of fails and complications of transcatheter coil occlusion of patent ductus arteriosus (PDA) was made. An attempt to close PDA with Gianturco coils was undertaken in 132 patients. Fails were noted in 4 (3.1%) children, 3 of them failed to hold the coil in PDA due to its greater width, and in 1 patient the catheter could not be delivered through a narrow duct. Complications were noted in 9 patients (7%): migration of the coils into the pulmonary artery branches took place in 8 patients, and in 1 patient there appeared haemolysis due to a large residual shunt. Snare-assisted removal of the migrating coils was carried out in 7 children, in 1 girl the coil could not be extracted from the peripheral branch of the left pulmonary artery. In 7 patients reocclusion of PDA was made, in 1 case no reembolization was performed. Haemolysis was liquidated by an additional implantation of the coils in repeated procedure. Risk of fail and complications was associated with great minimal diameter of patent ductus arteriosus.

Adolescent↗

PubMed1975

[Association of aortic coarctation with patent ductus arteriosus (analysis of clinical and surgical data].

A retrospective analysis of clinical and operative data was made covering 56 cases with combined coarctation of the aorta and patent ductus arteriosus. Prior to surgery both anomalies were recognized in 27 patients. Clinical data failed to furnish an reliable criteria as to the difference in anatomic variants of combined aortic coarctation and patent ductus arteriosus. The clinical picture and diagnosis of this congenital pathology are largely contingent upon the conspicuousness of each abnormality and consequently, on a definite orientation of the clinical diagnosis. There is a direct relation between the frequency of detection of the patent ductus arteriosus and its size.

Adolescent↗

PubMed1986

[Measurement by Doppler echocardiography of the pulmonary arterial pressure in children with ductus arteriosus. Simultaneous Doppler and hemodynamic study].

The aim of this study was to evaluate Doppler echocardiography in the non invasive assessment of pulmonary artery pressures in children with patent ductus arteriosus. Systolic pulmonary artery pressure was measured simultaneously at cardiac catheterisation and by pulsed Doppler in 11 children (mean age 1.8 +/- 2 years) with patent ductus arteriosus alone (6 cases) or associated with a malformation of the heart or great arteries (5 cases). Doppler assessment of systolic pulmonary artery pressure was performed by subtracting the value of the maximal pressure gradient between the aorta and pulmonary artery from the systolic systemic pressure measured simultaneously by sphygmomanometry. The maximal pressure gradient between the aorta and pulmonary artery was calculated using the modified Bernouilli formula and the maximal velocity (v) of the shunt flow (gradient = 4 v2). Ductal flow was recorded from the suprasternal approach by direct interrogation of the patent ductus visualised by 2D echocardiography. The systolic pulmonary arterial pressure measured by catheterisation ranged from 21 to 82 mmHg (mean 58 +/- 21 mm Hg) and by pulsed Doppler from 20 to 89 mm Hg (mean 56 +/- 24 mm Hg) (correlation r = 0.94). This study illustrates the value of Doppler echocardiography in the assessment of systolic pulmonary artery pressures in children with patent ductus arteriosus.

Blood Pressure Determination↗

PubMed1975

Ruptured ductus arteriosus. Aneurysm in an infant. Report of a survivor.

The diagnosis of a large ductus arteriosus aneurysm was made in a 3 1/2-month-old infant by cardiac catheterization following massive hemoptysis. Prompt surgical correction accounted for the patient's survival. Differential diagnosis of an intrathoracic mass should include a ductus arteriosus aneurysm even in the newborn period.

Diagnosis, Differential↗

PubMed2004

Patent ductus arteriosus remodels cardiac sensory neuronal chemotransduction.

We sought to determine the capacity of neonatal ventricular sensory nerve endings (neurites) to transduce the cardiac milieu in the presence of cardiovascular pathology. The spontaneous activity generated by nodose ganglion cardiac afferent neurons was identified in situ using extracellular recording techniques in two groups of piglets approximately 2 weeks old: (i). controls that underwent sham operations (n=19 piglets) 2 weeks earlier and (ii). a pathological model of patent ductus arteriosus stented open for about 2 weeks (n=16 piglets). The capacity of ventricular sensory neurites associated with nodose ganglion afferent neurons to transduce local mechanical (including alterations in right or left ventricular volumes) or chemical stimuli was studied in both groups. The average conduction velocity of afferent axons associated with identified neuronal somata was estimated to be 1.5+/-0.6 or 2.9+/-1.3 m s(-1). Ventricular afferent neurons transduced mechanical stimuli similarly in both groups. In control animals, ventricular afferent neurons transduced the following chemicals: the sodium channel modifier veratridine (delta 23+/-7 impulses min(-1)), the P(1)-purinoceptor agonist adenosine (Delta 24+/-8 impulses min(-1)), and the beta-adrenoceptor agonist isoproterenol (delta 18+/-7 impulses min(-1)). On the other hand, patent ductus arteriosus cardiac afferent neurons did not transduce these chemicals. It is concluded that neonatal cardiac afferent neuronal chemosensory-as opposed to mechanosensory-transduction remodels in the presence of a patent ductus arteriosus. The reduced capacity of neonatal cardiac afferent neurons to transduce chemicals in the presence of a patent ductus arteriosus should be taken into account when considering neonatal cardiovascular control in such a state.

Action Potentials↗

PubMed1977

Membranous subaortic stenosis and patent ductus arteriosus.

Six children (five of them girls) each initially had a large patent ductus arteriosus with auscultatory, radiologic, and electrocardiographic findings typical of that lesion. After surgery for the lesion, an ejection-type basal systolic murmur led to detection of discrete membranous subaortic stenosis, which became worse in late childhood. The murmur became louder, the systolic pressure gradient increased from slight to significant, and hypertrophic subaortic stenosis or aortic insufficiency (or both) developed in the older children. Surgical excision of the membrane afforded improvement, except in one patient with the most severe involvement. Because of the unexpected finding of discrete membranous subaortic stenosis in these infants and young children who had undergone surgery for a large patent ductus arteriosus and because of the treacherous worsening of the effects of the discrete membranous subaortic stenosis as childhood progressed, it is important that those patients with a persistent systolic murmur after ductal ligation not be discharged from cardiac follow-up as cured. Serial cardiac catheterization during the growing years appears to be the most accurate way of detecting worsening discrete membranous subaortic stenosis, so that the membrane can be excised before severe complications occur.

Angiocardiography↗

PubMed1976

Patent ductus arteriosus in premature infants. Indications for surgery.

In order to establish more objective criteria for surgical intervention, the literature and our clinical experience with operative closure of patent ductus arteriosus in 11 premature infants was reviewed. A wide range of age at the time of operation underscored the spectrum of clinical presentation and the difficulty of interpreting the course of therapy. The presence of a typical continuous murmur established the diagnosis of patent ductus arteriosus in patients with respiratory distress syndrome. Cardiac catheterization confirmed the diagnosis and provided quantitation of the left-to-right shunt flow through the ductus arteriosus in 6 patients but did not influence the decision to operate. Progress of the clinical course as determined by the heart size on chest roentgenogram and the presence of hypercarbia (Paco2greater than60 mm. Hg) after respiratory assistance and medical decongestive measures were the two most helpful signs indicating the need for surgical intervention.

Cardiac Catheterization↗

PubMed1978

Ligation of patent ductus arteriosus in the very low birthweight newborn infant.

Surgical closure of a patent ductus arteriosus was performed in 8 low birthweight infants suffering from cardiorespiratory failure secondary to a large left-to-right shunt. Mortality from the operation was nil, but only 4 (50%) ultimately survived. Earlier intervention may reduce mortality in these high-risk infants.

Ductus Arteriosus↗

PubMed2003

Absent pulmonary valve syndrome with intact ventricular septum and patent ductus arteriosus: report of two cases and a short review of the literature.

We describe two patients who both presented shortly after birth with congestive heart failure due to an absent pulmonary valve and patent ductus arteriosus. Diagnostic evaluation revealed in both cases an aneurysmatic dilation of the pulmonary vascular tree and an abundant left-to-right shunt over a large patent ductus arteriosus. Ventricular septal defects were not detected. Early surgical closure of the patent ductus arteriosus improved the hemodynamic situation so that implantation of a homograft valve could be delayed.

Ductus Arteriosus, Patent↗

PubMed1996

Aneurysm of a patent ductus arteriosus in an adult.

An adult patient with a spontaneous aneurysm of a patent ductus arteriosus was successfully treated. The lumen of the aneurysm communicated with the distal aortic arch and the pulmonary artery. Closure of the pulmonary arterial orifice of the ductus arteriosus and replacement of the inferior wall of the distal aortic arch and proximal descending aorta with prosthetic graft were performed under partial cardiopulmonary bypass using a centrifugal pump. The postoperative recovery was uneventful.

Diagnostic Imaging↗

PubMed1978

Real-time cross-sectional echocardiographic imaging and measurement of the patent ductus arteriosus in infants and children.

While echocardiography has been used to noninvasively document indirect effects on the heart of left-to-right shunting through a patent ductus arteriosus, no noninvasive technique has been developed to image the duct itself. In this study, 35 sequential studies were performed on 28 patients with a mechanical sector scanner to image the distal pulmonary artery and its bifurcation by scanning along the axis of the right ventricular outflow tract. Cross-sectional imaging, just superior to the take-off of the right pulmonary artery, provided visualization of the patent ductus as a distal continuation of the pulmonary artery connecting to the descending aorta. Ductal visualization by cross-sectional echo was validated by saline echo contrast observations of right-to-left and left-to-right shunting through the duct in 14 patients, by surgical observations in 11, angiographic observations in 13 and autopsy observations in three. Angiographic size of the ductus arteriosus, whether constricted or widely patent, tortuous or straight, was predicted correctly and echo/angiographic correlations for smallest inner ductal dimension were excellent (r = 0.97). This study provides a method for and validates the direct imaging of the ductus arteriosus and suggests that cross-sectional echocardiography can accurately predict ductal contour and quantitative ductal cross-sectional size noninvasively.

Adolescent↗

PubMed1999

Vasodilating effect and tissue accumulation of prostaglandin E1 incorporated in lipid microspheres on the rat ductus arteriosus.

Prostaglandin E1 incorporated in lipid microspheres (lipo PGE1) was administered to the umbilical vein of neonatal rats. Morphological measurement and quantitative autoradioluminography assessed the relationship between the vasodilating effect and tissue accumulation of lipo PGE1 in the ductus arteriosus. In the morphological measurement under microscopy, the inner diameter ratio of the ductus arteriosus to the main pulmonary artery after infusion of 3H-labeled lipo PGE1 (3H-lipo PGE1) continued to remain significantly higher than that of free 3H-PGE1. Autoradioluminography of the frozen frontal section of neonates after intravenous infusion of 3H-lipo PGE1 for 2 h revealed that the ductus levels of radioactivity were higher than those of free 3H-PGE1 in saline solution, although the blood levels were almost equal. Localization of lipo PGE1 labeled with a lipophilic fluorescent probe, 1,1'-dioctadecyl-3,3,3',3-tetramethyl-indocarbocyanine perchlorate (diI), in the endothelial cells of the ductus arteriosus was confirmed by confocal laser scanning microscopy. These findings suggest that the incorporation of lipid microspheres by the endothelial cells is one of the mechanisms that enables lipo PGE1 to accumulate to higher levels in the ductus tissue and to act more efficiently than free PGE1 in neonatal rats.

Alprostadil↗

PubMed1985

Ligation of patent ductus arteriosus in very low birthweight premature neonates.

The results of ligation of a patent ductus arteriosus in 30 premature neonates with a very low birth weight were analysed. The mean gestational age at birth was 27 weeks and the mean weight 811 g. Attempted closure of the ductus with indomethacin in 19 infants failed, though there was temporary closure in nine. Congestive heart failure was present in 29 and respiratory distress in 22 patients. Endotracheal intubation with assisted ventilation was necessary in all cases. The mean age at operation was 13.5 days and ductal ligation was performed in the intensive care unit under local anaesthesia supplemented with pancuronium and pethidine. There were no intraoperative deaths, but five infants died in hospital. There were seven late deaths. Eighteen survivors have been followed for a mean of 26.5 months. Early ligation of a patent ductus arteriosus in premature infants with a very low birth weight improved the cardiorespiratory state. Long term follow up showed good clinical progress in two thirds of the surviving group.

Ductus Arteriosus, Patent↗

PubMed1985

"Absent" pulmonary valve with atrial septal defect and patent ductus arteriosus.

The case of a newborn with "absent pulmonary valve," atrial septal defect, and patent ductus arteriosus is reported. He underwent surgical repair at five weeks of age, with closure of the patent ductus arteriosus and porcine pulmonary valve insertion. The clinical course leads us to suggest that reduction of pulmonary artery pressure and pulmonary valve competence will lead to prompt improvement in tracheobronchial compression and respiratory symptoms; no pulmonary arterioplasty is needed.

Abnormalities, Multiple↗

PubMed1994

Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils.

Retrograde coil embolization of the patent ductus arteriosus (PDA) has been reported for ducts < 3.3 mm in diameter using 5 to 5.5Fr catheters. Our objective was to assess the immediate and short-term results of anterograde transcatheter closure of the PDA using single or multiple Gianturco coils. Thirty-three patients (11 males and 22 females) underwent an attempt at transcatheter closure of the PDA anterogradely at a median age of 2.8 years (range 0.1 to 19) and median weight of 14 kg (range 2.3 to 64). The median PDA diameter at its narrowest segment was 2.8 mm (range 0.5 to 5.3). A 4Fr catheter was used for delivery of the coils in 30 patients and a 3Fr catheter was used in 3 patients. Eighteen patients underwent multiple coil closure for a PDA diameter of > or = 2.5 mm (using 2 coils in 9, 3 coils in 6, 4 coils in 1, and 5 coils in 2 patients). Follow-up evaluation was performed with color flow mapping of the main pulmonary artery. Thirty-one of the 33 patients had complete closure by the coil technique. The 2 unsuccessful attempts were in 2 patients with a large ductus measuring > or = 4.3 mm and of angiographic type B. For all 13 patients in whom a single coil and in 17 patients in whom multiple coils were placed, there was immediate complete closure that persisted at a median follow-up period of 3.8 months. The median fluoroscopy time was 24 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗

PubMed1985

Percutaneous transluminal angioplasty of stenotic ductus arteriosus.

This article describes our in vitro experience of balloon angioplasty of the ductus arteriosus (DA) in three post mortem human specimens, as well as an in vivo dilatation of a stenotic DA. The in vitro histologic observations revealed disruption of the intima and areas of pathologically fragmented and disorganized fibers at the media, with integrity of the ductal wall in all three DA. These findings led us to attempt percutaneous transluminal angioplasty (PTA) of a stenotic DA in a 2.3-kg newborn infant with hypoplastic left heart syndrome in a very deteriorated clinical condition. A Rashkind septostomy was associated with PTA of the stenotic DA. Following this, the gradients across the DA and across the atrial septum disappeared and the ductal angiographic diameter increased. Although an improved clinical condition was observed during the following hours, he died 1 day after. At necropsy, we found integrity of the ductal wall with histological changes similar to that observed in vitro. We conclude that PTA of stenotic DA could represent an alternative for palliative treatment of DA-dependent congenital heart disease.

Angioplasty, Balloon↗