ENDOVASCULAR TREATMENT OF THE PATENT DUCTUS ARTERIOSUS
Abstract
Correction of the patent ductus arteriosus (PDA) takes an important place in management of congenital heart defects (CHD). Untreated PDA can lead to heart failure due to left ventricular myocardial hypertrophy (LVH), pulmonary hypertension, bacterial endocarditis, pulmonary infection, and rarely the development of ductal wall aneurysm, its calcification and further rupture.
It is believed that the closure of PDA is indicated in any child or adult who develops pathognomonic symptoms: expansion of the left heart; the presence of signs of pulmonary hypertension with left-right blood discharge; prior endocarditis. In asymptomatic patients with PDA accompanied by left ventricular hypertrophy closure of the duct is indicated to reduce the risk of further complications.
There were various surgical methods of PDA treatment discovered in the period of the development of medical industry. Previously the most common intervention was ligation of the duct, accompanied by thoracotomy. However, in the present days the ligation of PDA is extremely rare. Endovascular occlusion has taken the lead in the modern practice. Its purpose is to close the duct with intravascular access with help of specialised tools.
In this article we present a case of PDA management in a patient with clinical manifestation of PDA at the age of 35 years.
About the Authors
A. N. Pakholkov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Surgeon, X-ray diagnosis and treatment department
350086, Krasnodar, 167, 1st May str.E. S. Suslov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Surgeon, X-ray diagnosis and treatment department
K. A. Lashevich
Kuban State Medical University, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Resident of department for cardiac surgery and cardiology department FAT.
A. N. Fedorchenko
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
Dr. of Sci. (Med.), head of the X-ray endovascular diagnostics and treatment department
V. A. Porhanov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health; Kuban State Medical University, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dr. of Sci. (Med.), professor, academician of the RAS, chief doctor; head of the Department of Oncology with the course of thoracic surgery
References
1. Сумароков А.Б., Бедимогова С.С., Некрутман Э.А., Епифанова О.Н., Веселова Т.Н., Атанесян Р.В. и др. Случай первичной диагностики открытого артериального протока у пациентки в возрасте 75 лет. Терапевтический архив. 2017;4:86-90. [Sumarokov A.B., Bedimogova S.S., Nekrutman E.A., Epifanova O.N., Veselova T.N., Atanesyan R.V. et al. The case of primary diagnosis of the patent ductus arteriosus in a patient aged 75 years. Terapevticheskiy arkhiv. 2017;4:86-90. (In Russ.)].
2. Клинические рекомендации по ведению детей с врожденными пороками сердца. Ассоциация сердечно-сосудистых хирургов России. М.; 2013. [Clinical guidelines for the management of children with congenital heart defects. Association of Cardiovascular Surgeons of Russia. Moscow; 2013. (In Russ.)].
3. Хирургическое лечение врожденных пороков сердца. Ричард А. Джонас/ пер. с англ. под ред. М.В. Борискова. М.: ГЭОТАР-Медиа, 2017. 736 с. [Surgical treatment of congenital heart defects. Richard A. Jonas: translation from English edited Boriskov M.V. М.: GEOTAR-Media, 2017. 736 р. (In Russ.)].
4. Врожденные пороки сердца: справочник для врачей. Кривощеков Е.В., Ковалев И.А., Шипулин В.М. Томск: STT, 2009. 286 с. [Congenital heart defects: a guide for doctors. Krivoshchekov E.V., Kovalev I.A., Shipulin V.M. Tomsk: STT, 2009. 286 р. (In Russ.)].
5. Открытый артериальный проток. Клинические рекомендации. Министерство здравоохранения Российской Федерации. Москва: 2016. 16 с. [Patent ductus arteriosus. Clinical guidelines. Ministry of Health of the Russian Federation. M.: 2016. 16 р. (In Russ.)].
6. Panagopoulus P.G., Tatooles C.J., Aberdeen E., Waterson D.J., Carter R.E.B. Patent ductus arteriosus in infants and children: a review of 936 operations (1946- 1969). Thorax. 1971;26:137-44.
7. Бокерия Л.А., Алекян Б.Г., Карденас Е.Э., Пурсанов М.Г. Закрытие больших открытых артериальных протоков с помощью Amplatzer Duct occlude. Руководство по рентгенэндоваскулярной хирургии. М.: 2005, С.167-182. [Bokeriya L.A., Alekyan B.G., Kardenas E.E., Pursanov M.G. Closure of large patent ductus arteriosus by the Amplatzer Duct occlude. Guide to endovascular surgery. Moscow: 2005. р. 167-182. (In Russ.)].
8. Клиническая ангиология: Руководство под ред. А.В. Покровского. В двух томах. Т1. М.: Медицина, 2004. 628 с. [Clinical Angiology: A Guide Ed. Pokrovsky A.V. In two volumes. V1. M.: Meditsina, 2004. 628 p. (In Russ.)].
9. Эндоваскулярная и минимально инвазивная хирургия сердца и сосудов у детей. Под ред. Л.А. Бокерия, Б.А. Алекяна, В.П. Подзолкова. М., НЦССХ им. А.Н. Бакулева РАМН. 1999, С. 189-202, С. 190- 212. [Endovascular and minimally invasive surgery of the heart and blood vessels in children. Ed. Bokeriya L.A., Alekyan B.A., Podzolkov V.P. M., NTSSSKH im. A.N. Bakuleva RAMN. 1999. р. 189-202, 190-212. (In Russ.)].
10. Сердечно-сосудистая хирургия. Руководство. Бураковский В.И., Бокерия Л.А. 1989; С.82 – 88. [Cardiovascular surgery. Guideline. Burakovskiy V.I., Bokeriya L.A. 1989. р. 82-88. (In Russ.)].
11. Porstmann W., Wierny L., Warneke H. Closure of the persistent ductus arteriosus without thoracotomy. Ger. Med. Mon. 1967;12:259 - 61.
12. Алекян Б.Г., Петросян С.Ю., Гарибян В.А. и д.р. Эндоваскулярная хирургия при лечении врожденных пороков сердца. Анналы хирургии. 1996;3:54-63. [Alekyan B.G., Petrosyan S.Yu., Garibyan V.A. et. al. Endovascular surgery in the treatment of congenital heart defects. Annaly khirurgii. 1996;3:54-63. (In Russ.)].
13. Amplatz K. Percutaneous closure of patent ductus arteriosus with angled disk device, AGA 3rd International Amplatzer Symposium (abstr.) Strasburg. June 13.2000.
Review
For citations:
Pakholkov A.N., Suslov E.S., Lashevich K.A., Fedorchenko A.N., Porhanov V.A. ENDOVASCULAR TREATMENT OF THE PATENT DUCTUS ARTERIOSUS. Innovative Medicine of Kuban. 2018;(4):29-33. (In Russ.)
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