Doctors Lounge - Pediatrics Answers
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Forum Name: Pediatric Topics
Question: Patent Ductus Arteriousus-Infant/Toddler
|JLRBobbe - Wed Oct 05, 2005 8:30 pm||
To Whom It May Concern, my daughter, who just turned 1 on Oct.4th, 2005, was diagnosed 6 months ago with PDA by a pediatric cardiologist. The cardiologist will be seeing her on Oct. 13th for another echocardigram(spelling?) and set her up for Heart Catheterization. I am very nervous about this procedure as she is so tiny. What questions should I be asking the Doctor's about her condition and this procedure? What as a parent should I do to educate myself on this subject? I appreciate your time and information in advance. Procedure will be done at UC Davis Medical Center, in Sacramento, California.
|Dr. Heba Ismail - Fri Oct 07, 2005 3:12 pm||
After the first birthday, the most common treatment for a PDA is occlusion at cardiac catheterization.
Today, the most common device used for PDA occlusion is a Gianturco spring occluding coil. In experienced hands with proper patient selection, this has become a procedure associated with high success and low morbidity. Coil occlusion is best suited to close PDAs with a minimal internal diameter of less than 2.5 mm. Success is usual with a PDA diameter of 2.5-3 mm, but larger PDAs probably are best served by alternate techniques.
Typically, complete occlusion is achieved at catheterization. Occasionally, a tiny residual shunt remains at the end of the procedure, which closes by thrombus formation over the following days or weeks. If this does not occur, residual shunt closure can be accomplished with a second catheter procedure.
Procedural risks of PDA occlusion by catheter are few and largely influenced by the experience of the physician performing the procedure. These risks include embolization of the device being used to occlude the PDA, blood vessel injury, and stroke. In the case of device embolization, the device usually can be retrieved by transcatheter techniques, and a second device can be successfully placed in the PDA.
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