• 한국임상수의학회지
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• 제19권1호
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• pp.95-99
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• 2002

A 6-month-old, intacted male dog was admitted to Seoul Animal Medical Center. The referring veterinarian suspected that the patient might have congenital cardiac problem. It was diagnosed with patent ductus arteriosus(PDA) based on the physical examination, auscultation, radiography, electrocardiography and ultrasonogrphy. After surgical ductus closure, there were improved clinical conditions through by alleviation of atrial fibrilation and left heart enlargement.

• 대한수의학회지
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• 제56권4호
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• pp.209-213
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• 2016

This study evaluated several known echocardiographic markers related to the assessment of severity in dogs with patent ductus arteriosus (PDA) after the closure of ductus arteriosus (DA). Forty-two dogs with patent ductus arteriosus were enrolled in this study. Evaluated echocardiographic markers were left atrial to aortic root ratio, left ventricular end-diastolic dimension to aortic root ratio, indexed left ventricular end-diastolic and end-systolic dimensions, end-diastolic and end systolic volume index, pulmonic flow to systemic flow (Qp/Qs) ratio, velocities of pulmonary regurgitant and systolic jets, pulmonary flow profiles and the presence of mitral regurgitation. Those markers were evaluated before, 1 day, and 30 days after the closure of DA. Statistically significant changes in some echocardiographic markers (i.e., Qp/Qs) were observed. Although several studies in human and dogs have evaluated the clinical outcome of PDA occlusion using several echocardiographic markers, this study has firstly evaluated all echocardiographic markers known to be useful for assessing the clinical outcome of PDA occlusion in human, and has demonstrated that those markers including the Qp/Qs and pulmonary flow profiles were useful in evaluating of clinical outcome of PDA in dogs and the reduction of LA and LV preload after ductal closure could dramatically reduce after successful ductal occlusion of PDA in dogs.

• Journal of Chest Surgery
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• 제33권1호
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• pp.85-87
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• 2000

Patent ductus arteriosus(PDA) is a common congenital heart disease encountered in premature neonates infants and children. Patent ductus arteriosus was the first surgically managed congenital heart disease,. Classic surgical interruption of patent ducturs arteriosus was partially replaced by a transcatheter endovascular closure, After a 5-7 mm video-assisted thoracoscopic interruption of the patent ductus arteriosus first applied in 1991, this minimally invasive technique came to be used in many centers, Video-assisted thoracoscopic interruption of the patent ductus arteriosus is feasible in low-weight infants whereas transcatheter endovascular closure of the ductus is usually not possible. We experienced successful outcome for the treatment of patent ductus arteriosus with 2 mm video-assisted thoracoscopic titanium clipping, We believed that this technique is a simple safe and rapid method for closure of the patent arteriosus.

• Journal of Chest Surgery
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• 제20권4호
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• pp.786-792
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• 1987

Congenitally corrected transposition of the great arteries is a congenital cardiac anomaly with ventriculoarterial discordant connection and atrioventricular discordant connection. This report describes a 17 year old male patient who had congenitally corrected transposition of the great arteries associated with ventricular septal defect and patent ductus arteriosus, underwent patch closure of the ventricular septal defect and suture closure of patent ductus arteriosus, and was discharged on 9th day after surgery with good condition.

• Journal of Chest Surgery
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• 제24권1호
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• pp.8-14
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• 1991

Methods for the operative management of patent ductus arteriosus are now well established, and in the vast majority of children the circulatory shunt can be safely and effectively abolished by dividing the ductus or by closing it in continuity with ligatures and transfixing sutures. In adults, however, closure of patent ductus arteriosus may pose important technical problems, particularly when there are associated pulmonary hypertension, calcification, aneurysm and infective endocarditis. Under these circumstance, division or ligation is unusually hazardous because the diseased vessels often fracture or tear when sutures are placed in them. Then we closed the patent ductus arteriosus by use of cardiopulmonary bypass in 18 patients and ligated the ductus via thoracotomy in 18 patients from Jan. 1986 to May 1990. And we compared the results between two different methods. We concluded that ligation of ductus had a problem of rupture and transpulmonary internal suture closure of PDA had a problem of injury of recurrent laryngeal nerve.

• Clinical and Experimental Pediatrics
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• 제53권12호
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• pp.1012-1017
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• 2010

Purpose: Transcatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center. Methods: Between January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable $Coil^{(R)}$, PFM Nit-$Occlud^{(R)}$, or Amplatzer duct $occluder^{(R)}$. A retrospective review of the treatment results and complications was performed. Results: The mean age of patients was $9.1{\pm}5.9$ months (median, 8 months), and mean weight was $7.6{\pm}1.8kg$ (median, 7.8 kg). The mean diameter of PDA was $3.2{\pm}1.4mm$ (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was $3.0{\pm}3.3$ days, and mean follow-up duration was $21.0{\pm}19.6$ months. There were no major complications in any of the patients. Conclusion: Transcatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.

• Clinical and Experimental Pediatrics
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• 제61권12호
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• pp.397-402
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• 2018

Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed. Results: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was $3.3{\pm}1.5months$, and weight was $5.7{\pm}1.3kg$. The duct diameter at the narrowest point was $3.0{\pm}0.8mm$ as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01). Conclusion: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.

• Journal of Chest Surgery
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• 제21권4호
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• pp.672-680
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• 1988

Munro is generally considered the first person to have demonstrated, in 1888, in an infant cadaver, the feasibility of dissection and ligation of a persistently patent ductus arteriosus. In august, 1938, Robert Gross reported first successful division and suture of the patent ductus of 7 year old girl. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. Seventy-eight consecutive cases of closure of patent ductus arteriosus were operated from June 1980 to June 1988 in the department of thoracic and cardiovascular surgery in Maryknoll Hospital. Retrospective clinical analysis of the patients were 1. There were 24 males, 54 females. 2. The age range of the patients were from 7 months to 32 years with the mean age 9.8 years. 3. Chief complaints of the patients were frequent URI[70.5%], dyspnea on exertion[36.9%], palpitation[10.3%], but 15 patients[19.2%] had no subjective symptoms. 4. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 66 patients[84.6%]. The other 12 patients made systolic murmur. 5. Radiographic findings of the Chest P-A were cardiac enlargement in 55 patients[70%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 68 patients[87%]. 6. Electrocardiographic findings of the patients were within normal limit in 23 patients[36%], LVH in 38 patients[48.7%], RVH in 7 patients[9%], biventricular hypertrophy in 5 patients[6%]. 7. Cardiac catheterization performed in 62 patients. Mean Qp/Qs=2.5, mean pulmonary arterial pressure=45 mmHg. 8. 73 patients were operated through left posterolateral thoracotomy: Closure of the ductus by ligation in 64 cases, division with suture in 6 cases, and division with aortopatch in 3 cases. Ligation through median sternotomy under cardiopulmonary bypass were 5 cases. 9. There was no death associated with operation, but one case was experienced with intraoperative tearing of ductus resulting in massive bleeding. The other complications were transient hoarseness in 2 patients, chylothorax in 2 patients.

• Journal of Chest Surgery
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• 제31권3호
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• pp.311-314
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• 1998

68세된 고령의 여자 환자에서 폐고혈압과 동맥관 및 주변 대동맥의 석회화 병변이 동반된 동맥관개존증이 발견되어 Porstmann 술식을 이용해 성공적으로 폐쇄시켰다. 저자 등은 Rashkind 술식이 부적당하거나 실패한 일부 경우에서 Porstmann 술식이 개흉술을 대치할 수 있는 경침습 외과적 도관 폐쇄술로서 의의가 있다고 본다.

• Clinical and Experimental Pediatrics
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• 제52권9호
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• pp.1035-1037
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• 2009

동맥관 개존증은 선천성 심질환 중 비교적 흔한 질환이며, 크기나 중등도에 상관없이 폐쇄가 필요한 질환이다. 경피적 동맥관 폐쇄술은 개흉술에 비하여 합병증의 위험이 적고 경제적으로도 바람직하며, 치료 성적도 우수하여 최근에는 표준적인 치료법으로 받아들여지고 있다. 하지만 원통형 모양의 동맥관 개존증은 흔히 사용하는 분리형 코일이나 ADO로 시술하기에는 여러 가지로 어려운 점이 많다. 저자들은 이러한 형태의 동맥관을 폐쇄하기 위하여 일반적으로 추천되는 것보다 큰 크기의 AVP를 이용하여 원통형 동맥관이 메워지도록 하는 방법을 이용함으로써, 성공적인 동맥관 개존증 폐쇄술을 시행하였기에 이를 보고하는 바이다.