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October 1969

Surgical Management of Patent Ductus Arteriosus in Infancy

Author Affiliations

Torrance, Calif
From the departments of surgery (Drs. Cleveland, Nelson, and Bloomer), pediatrics (Dr. Emmanoulides), and anesthesiology (Dr. Lippmann), Harbor General Hospital, Torrance, Calif, and the University of California at Los Angeles School of Medicine, Los Angeles.

Arch Surg. 1969;99(4):516-520. doi:10.1001/archsurg.1969.01340160096022

Congenital cardiovascular abnormalities remain a major cause of infant mortality. The incidence of congenital cardiovascular defects approximate 0.3% to 0.8% of all births. MacMahon et al1 estimate that 25% of infants with major cardiovascular defects will die within the first month of life, and that 60% will die within the first year.

Isolated patent ductus arteriosus, a readily corrected defect, accounts for about 15% of all congenital cardiovascular anomalies. During the first year of life, approximately 15% of patients with patent ductus arteriosus will develop either overt signs of cardiac failure, cardiomegaly, electrocardiographic abnormalities, repeated respiratory tract infection, dyspnea, or evidence of retarded growth.2

The mortality of elective surgical closure of a patent ductus arteriosus has been shown to be extremely low,3 and the value of operation in infancy has been increasingly recognized. Indeed, procrastination because of age or size in infants with congestive heart failure secondary to

McMahon, B.; McKeown, T.; and Record, R.G.:  The Incidence and Life Expectancy of Children With Congenital Heart Disease ,  Brit Heart J 15:121-129 ( (April) ) 1953.Crossref
Jones, J.C.:  Twenty-five Years Experience With the Surgery of Patent Ductus Arteriosus ,  J Thorac Cardiovasc Surg 50:149-165 ( (Aug) ) 1965.
Wilcox, W.R., and Peters, R.M.:  The Surgery of Patent Ductus Arteriosus: A Clinical Report of 14 Years Experience Without an Operative Death ,  Ann Thorac Surg 3:126-131 ( (Feb) ) 1967.Crossref
Northway, W.H., Jr.; Rosan, R.C.; and Porter, D.Y.:  Pulmonary Disease Following Respirator Therapy of Hyaline-membrane Disease ,  New Eng J Med 276:357-368 ( (Feb) ) 1967.Crossref
Robinson, F.R., et al:  Proliferative Pulmonary Lesions in Monkeys Exposed to High Concentrations of Oxygen ,  Aerospace Med 38:481-486 ( (May) ) 1967.
Siassi, B., et al:  Patent Ductus Arteriosus Complicating Prolonged Assisted Ventilation in Respiratory Distress Syndrome ,  J Pediat 74:11-19 ( (Jan) ) 1969.Crossref
Trusler, G.A.; Arayangkoon, P.; and Mustard, W.T.:  Operative Closure of Isolated Patent Ductus Arteriosus in the First Two Years of Life ,  Canad Med Assoc J 99:879-881 ( (Nov) ) 1968.
Danilowicz, D.; Rudolph, A.M.; and Hoffman, J.I.:  Delayed Closure of the Ductus Arteriosus in Premature Infants ,  Pediatrics 37:74-78 ( (Jan) ) 1966.
Emmanoulides, G.C.; Linde, L.M.; and Crittenden, I.H.:  Pulmonary Artery Stenosis Associated With Ductus Arteriosus Following Maternal Rubella ,  Circulation 29:514-522 ( (April) ) 1964.Crossref
Auld, P.A.:  Delayed Closure of the Ductus Arteriosus ,  J Pediat 69:61-66 ( (July) ) 1966.Crossref
Jegier, W.; Karn, G.; and Stern, L.:  Operative Treatment of Patent Ductus Arteriosus Complicating Respiratory Distress Syndrome of the Premature, abstracted ,  Canad Med Assoc J 98:105 ( (Oct) ) 1968.