Paediatrica Indonesiana
Vol 29 No 3-4 (1989): March - April 1989

Patent Ductus Arteriosus Before and After Surgery

Bambang Madiyono (Department of Child Health, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta,)
Ismet N. Oesman (Department of Child Health, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta,)
Sudigdo Sastroasmoro (Department of Child Health, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta,)
Sukman Tulus Putra (Department of Child Health, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta,)
Eva Jeumpa Soelaiman (Department of Child Health, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta,)
Kukuh Basuki Rachmad (Department of Surgery, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta)



Article Info

Publish Date
28 Apr 1989

Abstract

Twenty five patients with patent ductus arteriosus, who had undergone surgical closure were studied retrospectively. Girls were more affected than boys; the sex ratio was 4 : I. Associated cardiac lesions were diagnosed in 3 patients, two with ventricular septal defect and one with congenital mitral stenosis. Congestive heart failure was diagnosed in 5 patients before surgery. Typical continuous murmur was heard in most cases (76%), while in the rest only systolic murmur was detected. Electrocardiographic left atrial enlargement, left ventricular hypertrophy and right ventricular hypertrophy were found in 8%, 48% and 40%, respectively.Cardiomegaly with increased pulmonary vascular markings was found in 60% of cases, while ratio of left atrial to aortic root diameter greater than 1.2 was detected in 60% of patients. The PDA could be directly visualized by echocardiography in 15 cases.Cardiac catheterization was performed in 17 cases, 47% with hyperkinetic pulmonary hypertension, 41% with high pulmonary flow without pulmonary hypertension and 12% with mild increased pulmonary flow. The pulmonary-systemic flow ratio (Qp/Qs) was more correlated to pulmonary vascular markings rather than to cardio-thoracic ratio. Division of the ductus was the procedure of choice, but in 16% of cases ductal ligation was performed because of technical reasons. Postoperative catch-up in both weight and height was observed more clearly in children operated at earlier age. Ejection systolic murmur was still detected in 2 patients, in whom hyperkinetic pulmonary hypertension existed prior to surgery. No cardiomegaly was found in patients followedup I year or more after surgery. The mortality was nil.

Copyrights © 1989






Journal Info

Abbrev

paediatrica-indonesiana

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of ...