How to treat patent ductus arteriosus

How to treat patent ductus arteriosus? Patent ductus arteriosus is common, accounting for 15% of the total number of congenital heart diseases. It is more common in women and is a type of congenital heart disease. It is very harmful to children. Therefore, it must be treated as soon as possible. However, many parents are not very familiar with the treatment methods of patent ductus arteriosus. Let's take a look at how to treat patent ductus arteriosus.

1. Surgical Method

(1) Simple ligation (double ligation + suture) is a safe, simple and effective method suitable for tubular patent ductus arteriosus.

(2) Catheter anterior wall padding ligation: suitable for children with severe pulmonary hypertension.

(3) Cutting and suturing is ideal, but the operation is more complicated and there is a risk of heavy bleeding.

2. Radiological interventional treatment can now also be used for funnel-shaped patent ductus arteriosus.

3. Treatment of patent ductus arteriosus in premature infants

(1) If the ductus arteriosus does not close at 24 s after indomethacin treatment and the symptoms do not improve, or if hypoxemia and hypercapnia persist despite adequate ventilation and oxygen support, and PC02>7.98 kPa (60 mmHg), simple ductus ligation should be performed urgently.

(2) Indomethacin treatment: Patients who have not responded to anti-heart failure treatment should be given indomethacin by nasogastric feeding. One dose every 8 hours, for a total of 3 times. Before medication, the white blood cell count should be within the normal range, platelets should be no less than 60×109/L (60,000/mm3), urea nitrogen <20mg, and bilirubin <12mg. Urine volume, heart rate, appetite, and jaundice should be observed during medication. After medication, urea nitrogen, electrolytes, echocardiography, and chest X-ray should be rechecked. Adverse reactions of indomethacin include renal failure, hyponatremia, worsening jaundice, bone marrow suppression causing thrombocytopenia and coagulation disorders.

4. Medical treatment

Prevent and treat infective endocarditis, respiratory tract infection and heart failure. For premature infants with patent ductus arteriosus, 0.2-0.3 mg/kg of indomethacin or 20 mg/kg of aspirin can be taken orally 4 times a day to inhibit prostaglandin synthesis and close the ductus. For older children or adults with pulmonary hypertension, tamponade or closure agents can be injected through the catheter to block the shunt.