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May 23, 1977

Medical Treatment Leads to Closure of Patent Ductus Arteriosus

JAMA. 1977;237(21):2326. doi:10.1001/jama.1977.03270480066026

Elliott et al1 were probably the first to indicate that prostaglandin E1 infused into infants enlarged the patency of ductus arteriosus. Their findings also suggested that administration of a nonspecific antagonist of prostaglandin synthesis, such as indomethacin, was associated with a fall in arterial saturation.

Cotton et al2 showed that medical management of symptomatic ductus arteriosus shunts in small preterm infants is possible. They used digitalis, mechanical ventilation, and transfusions. Although the results of medical management indicated the effectiveness of conservative means, Cotton considered that surgical treatment may be unavoidable in life-threatening situations.

Pharmacologic closure of patent ductus arteriosus using indomethacin was achieved by Friedman et al.3 Within 24 hours, all the clinical symptoms and signs attributable to left-to-right shunting dramatically and permanently disappeared in infants receiving the drug.

Heymann et al4 reported their experience with 18 infants who had cardiac failure associated with persistent