TITLE:
Surgical Closure of Isolated Patent Ductus Arteriosus in Cenhosoa Antananarivo
AUTHORS:
Zakarimanana Lucas Randimbinirina, Harijaona Fanomezantsoa Randrianandrianina, Tsirimalala Rajaobelison, Rija Mikhaël Miandrisoa, Hariniaina Ravaoavy, Toky Mamin’ny Aina Rajaonanahary, Andriamihaja Jean-Claude Rakotoarisoa
KEYWORDS:
Echocardiography, Patent Ductus Arteriosus, Pediatrics, Surgery, Thoracotomy
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.13 No.7,
July
10,
2023
ABSTRACT: Introduction: Patent ductus arteriosus (PDA) is a congenital heart disease whose seriousness lies in the risk of pulmonary
hypertension, congestive heart failure
and death. The aim of this study was to describe the surgical closure of an isolated patent ductus arteriosus (PDA)
performed in Soavinandriana Teaching Hospital. Methods: This was a
retrospective and descriptive study, during thirteen-years-period (January 2004
to December 2016), performed at Cardiac
surgery unit of Soavinandriana Teaching Hospital, including all children underwent surgical closures of an isolated PDA. Demographic data, birth weight,
clinical signs, diagnostic imaging, time between diagnosis and surgery and
hospital left stays were analyzed. Results: A total of eighty-six children were recorded, including 21 males
(24.42%) and 65 females (75.58%), giving
sex ratio of 30%. The average age was 33.91 months. Children were born with a low birth
weight in 12.79% of cases. PDA was symptomatic in 81.39%. The most circumstances of discovery were recurrent
lung infections (31.40%), dyspnea (24.41%) and failure to thrive
(19.76%). Echocardiography showed left
ventricular dilatation (63.95%), pulmonary hypertension (73.25%). The
ductus was large in 97.67% and the mean diameter was 5 mm. Chest X-ray showed cardiomegaly (97.67%) and increased
pulmonary vascularity (86.04%). Mean delay of surgical procedures after
diagnosis was 15.16 months. Surgical procedures consisted left posterolateral
thoracotomy with a section and suture after clamping the ductus. Earlier
postoperatives courses were simple in all children. The mean duration of
hospitalization was 8.93 days. Conclusion: PDA was most common large
(97%) and symptomatic (81%) in our study.
Surgical closure of an isolated PAD was the only surgical procedure of
congenital heart cardiopathy available in Antananarivo.