Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T08:13:01.088Z Has data issue: false hasContentIssue false
  • English
  • Français

Patency or recanalization of the arterial duct after surgical double ligation and transfixion

Published online by Cambridge University Press:  22 December 2006

Tevfik Demir ,
Funda Öztunç ,
Gürkan Çetin ,
Levent Saltik ,
Ayse Güler Eroglu ,
Kadir Babaoglu  and
Gülay Ahunbay
Tevfik Demir
Affiliation:
Department of Pediatric Cardiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
Funda Öztunç
Affiliation:
Department of Pediatric Cardiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
Gürkan Çetin
Affiliation:
Department of Cardiac Surgery, Istanbul University Cardiology Institute, Istanbul, Turkey
Levent Saltik
Affiliation:
Department of Pediatric Cardiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
Ayse Güler Eroglu
Affiliation:
Department of Pediatric Cardiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
Kadir Babaoglu
Affiliation:
Department of Pediatric Cardiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
Gülay Ahunbay
Affiliation:
Department of Pediatric Cardiology, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: The frequency of residual shunting or recanalization was investigated in patients in whom a persistently patent arterial duct had been doubly ligated and transfixed during surgical closure. Methods: We investigated in retrospective fashion for any residual shunting 325 patients who, between January 1990 and December 2004, had undergone surgical double ligation and transfixion of a persistently patent arterial duct. Shunting was discovered in 10 patients, of whom four male and six female. Results: Of those with residual shunting. 4 patients had initially exhibited only persistent patency of the duct, while the other 6 had associated mild cardiac lesions. The mean age at operation was 5.5 years, with a range from 0.5 to 17.9 years. Postoperatively, the mean period for detecting the residual shunt was 22.8 months, with a range from 2 days to 72 months. The frequency of residual shunting amongst our patients, therefore, was 3.1%. We detected the residual shunt by colour-flow Doppler mapping in all patients, although a continuous murmur was heard in only one patient on physical examination. Conclusion: Our findings suggest that clinical sensitivity of detecting residual shunting subsequent to surgical closure of the persistently patent arterial duct is low, and hence that colour-flow Doppler interrogation should be a part of follow up. Residual shunting, or recanalization, may occur even after double ligation and transfixion of the duct. Since the residual flow may emerge after months, or even years, follow-up is needed for longer periods.

Keywords

Patent ductus arteriosusresidual shuntingcongenital heart disease
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 1 , February 2007 , pp. 48 - 50
Copyright
2007 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Campbell M. Natural history of persistent ductus arteriosus. Br Heart J 1968; 30: 4–13.Google Scholar
Gross RE, Hubbard JP. Surgical ligation of a patent ductus arteriosus: report of first successful case. J Am Med Assoc 1939; 112: 729–731.Google Scholar
Jones CJ. Twenty-five years experience with surgery of patent ductus arteriosus. J Thorac Cardiovasc Surg 1965; 50: 149–165.Google Scholar
Musewe NN, Benson LN, Smallhorn JF, Freedom RM. Two-dimensional echocardiographic and color flow Doppler evaluation of ductal occlusion with the Rashkind prosthesis. Circulation 1989; 80: 1706–1710.Google Scholar
Sorensen KE, Kristensen BO, Hansen OK. Frequency of occurrence of residual ductal flow after surgical ligation by colorflow mapping. Am J Cardiol 1991; 67: 653–654.Google Scholar
Zucker N, Qureshi SA, Baker EJ, Deverall PB, Tynan M. Residual patency of the arterial duct subsequent to surgical ligation. Cardiol Young 1993; 3: 216–219.Google Scholar
Schmaltz AA, Reidemeister JC, Neudorf U, Doetsch N, Hentrich F. Residual shunts after surgical ductus ligation. Z Herz Thorax Gefasschir 1994; 8: 91–94.Google Scholar
Podnar T, Masura J. Transcatheter occlusion of residual patent ductus arteriosus after surgical ligation. Pediatric Cardiol 1999; 20: 126–130.Google Scholar
Swensson RE, Valdes-Crus LM, Sahn DJ, et al. Real-time Doppler color flow mapping for detection of patent ductus arteriosus. J Am Coll Cardiol 1988; 8: 1105–1112.Google Scholar
Pui-Kan L, Wen-Jen S, Jui-Sung H. Doppler echocardiographic flow characteristics of isolated patent ductus arteriosus: better delineation by Doppler color flow mapping. J Am Coll Cardiol 1988; 12: 1285–1291.Google Scholar