The indications for operating upon a patent ductus arteriosus have now become so well established that virtually all groups recommend closure after 4 or 5 years of age, regardless of whether the ductus is causing symptoms. We are inclined to recommend operation after 3 years of age, and we have not refused operation to any patient on the basis of age.
In recent years an increasing number of patients have been found whose clinical picture differs from the classical.* Many of these are infants who develop heart failure or severe symptoms, children or adults who have an associated pulmonary hypertension, and those who have associated cardiac or great-vessel abnormalities. It is the purpose of this paper to report our experiences in treating 18 infants less than three years of age who had serious symptoms from patent ductus, 11 children and adults who had pulmonary hypertension in association with patent ductus
GERBODE F, HOLMAN E, HULTGREN H, et al. Atypical Patent Ductus: Results of Surgical Treatment in Infants, Patients with Pulmonary Hypertension, and Patients with Coarctation of the Aorta. AMA Arch Surg. 1956;72(5):850–862. doi:10.1001/archsurg.1956.01270230114014
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