Analysis Of Patent Ductus Arteriosus

One of the most common surgeries performed on babies is called Esophageal Atresia/Tracheoesophageal Fistula. That is just the medical term for when a baby is born with a defect in their esophagus and trachea and needs to have it repaired. About 90% of babies are born with this condition. It occurs in 1 in 3,000 to 5,000 newborns. The good thing is that since it happens so frequently, the survival rate is almost 100%. The most rarest condition is ectopia cordis. That is when a baby is born with their heart outside of their chest. Ectopia Cordis occurs 8 per one million live births. The survival rate is very low. 90% of the babies are either stillborn or pass away within the first week of being out of the womb.

Premature babies sometimes have apnea. It may happen together with a slow heart rate. Respiratory distress syndrome or RDS is a breathing problem most common in babies born before 34 weeks of pregnancy.” Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. “Intraventricular hemorrhage or IVH is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid. Patent ductus ateriosus or PDA is a heart problem that happens in the connection between two major blood vessels near the heart. If the ductus do not close properly after birth, a baby can have breathing problems or heart failure. Heart failure is when enough blood can’t get pumped into the heart causing it to shut down. Necrotizing enter colitis (NEC) is a problem with a baby’s intestines. It causes feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature bay has been born. Retinopathy of prematurity (ROP) is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss. Jaundice is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well. Anemia is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body. Bronchopulmonary dysplasia (BPD) is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and

The blood that does not cross the foramen ovale into the left atrium is emptied into the right ventricle which is then pumped into the pulmonary artery to be carried to the lungs. The third fetal shunt is encountered; the ductus arteriosus allows blood to be shunted from the pulmonary artery to the aorta and systemic arteries following. Blood that does go to the lungs are returned by the pulmonary veins to the left atrium and emptied into the left ventricle. (Perinatal and Pediatric Respiratory Care, Ch2 p 17-18) Shortly after birth due to changes in vascular resistance blood is redirected to the lungs for oxygenation and these shunts are no longer required leading to their closure within a few days postpartum. In HLHS, because the left heart structures are insufficient to receive and pump adequate amounts of oxygenated blood to supply the tissues the patency of the foramen ovale and the ductus arteriosus are essential to sustaining life. (PubMed – ADAM Medical Encyclopedia, 2013) Medical intervention is needed to maintain the patency of the ductus arteriosus and an atrial septal defect is created in place of the foramen ovale.

Heredity plays a role in atrial septal defect because of gene abnormalities and environmental exposure that heighten the chance of a child inheriting it. Although most ASD occur by chance with no clear cause, scientists are still searching for a reason to why it occurs. Some symptoms of atrial septal defect after birth include recurrent respiratory or lung infections, trouble in breathing, feeling drained when feeding (infants), being out of breath when doing physically intensive activities, missed heartbeats, heart murmurs, swelling of limbs such as feet, legs, or stomach areas, or getting a stroke. Detection can be done during of after the baby is born. During pregnancy, it may be seen during an ultrasound but it usually depends on the size of the hole and its location. In many cases, ASD is not detected until adulthood, in which detection can be done through x-rays or physical examination which is done with a stethoscope to check for heart murmurs. Treatment may not be necessary in most cases of ASD as the hole in the septum closes during childhood but more severe cases will require treatment. Medications can be used to reduce the signs of symptoms and infections as well as aiding the heart to

Patent Ductus Arteriosus is a common condition seen in preterm infants. PDA may cause congestive heart failure, respiratory distress, necrotizing enterocolitis, and renal impairment. Cyclooxygenase (COX) inhibitors and surgical interventions for ligation of PDA are widely used in management of this condition. In small infants, surgical closure can be difficult, therefore medical closure offers a great advantage.

Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth (Weinrauch, 2015). Congenital heart disease is divided into two types, cyanotic (turns the skin blue due to a lack of oxygen) and non-cyanotic. Cyanotic heart diseases include Ebstein’s anomaly, tricuspid atresia, tetralogy of Fallot, Truncus arteriosus, transportation of the great vessels, pulmonary atresia, hypoplatstic left heart, and total anomalous pulmonary venous return. Non-cyanotic heart diseases include aortic stenosis, pulmonic stenosis, patent ductus arteriosus (PDA), arterial septic defect (ASD), coarctation of the aorta, ventricular septal defect (VSD), and atrioventricular canal (endocardial cushion defect).

Pulmonary valve stenosis is a heart problem some children are born with (congenital heart defect). This defect is a stiffening or narrowing (stenosis) of a one-way valve in the heart. It is the valve that allows blood to flow from the pumping chamber on the right side of the heart (right ventricle) into the blood vessel that carries blood to the lungs. If not enough blood is flowing through the valve, not enough oxygen will get into your child’s blood. The child’s heart will also be forced to work harder.

An atrial septal defect (ASD) is a hole in the heart. This hole is located in the thin tissue (septum) that separates the two upper chambers of the heart, the right and left atrium. This hole is present at birth (congenital). A few minutes after birth, this hole normally closes so that blood is not able to go between the right and left atrium.

Every isolated PDA needs closure beyond 3 months of age except for silent ducts, Eisenmenger ducts and ducts in premature infants. Percutaneously closure of PDA with device is an established modality of treatment worldwide and is regarded as safe and effective. Important information to have a successful duct occlude include age and weight of the patient, size and the experience of the center and operator. The PDA device closure is considered in infant with age beyond 6 months and weight of more than 6 kgs. If PDA is directly responsible for CHF, felling to increase duct closure is indicated as soon as possible. Early closure of PDA improve cardio-respiratory status and as a importance long-term follow-up

Congenital abnormalities have become the main cause of heart disease among children especially in developing countries including Palestine state. Congenital heart disease is the most frequent form of congenital anomaly in newborn infants, and accounts for more than a quarter of all serious congenital anomalies worldwide. Generally, an estimated incidence of eight cases of congenital heart disease per 1000 live births is internationally accepted as the best approximation. The causes of most congenital heart defects are not known. (Zaqout, Aslem, Oweida, Al Kahlout, Al Barqouni, and De Wolf, 2013)

Congenital heart disease occurs in approximately 1% of newborns and nearly 10% of these malformations belong to the group of univerntricular heart [Ref]. In patients with univentricular heart, the functioning ventricle receives the flow of both pulmonary and systemic circulation which causes a volume overload in the ventricle and reduces the functional ability of heart. In early 70’s, Fontan and Baudet introduced a palliative surgical technique aiming at reducing overload of heart in patients with tricuspid atresia by separating systemic and pulmonary venous return. Since the original technique was firstly introduced, it has been adapted greatly and applied to the patients with univentricular heart. Currently, the infants with univentricular heart undergo multiple consecutive operations with the final surgical operation creating so called Fontan circulation. The Fontan circulation separates systemic and pulmonary venous return by creating a direction connection between caval veins and pulmonary arteries. Two surgical approaches, which are called intracardiac lateral tunnel (ILT) [Ref] and extracardiac conduit (ECC) [Ref], are favoured to create Fontan circulation. ILT approach involves placement of an intraatrial baffle (figure 2a) while ECC approach creates anastomosis between pulmonary arteries and inferior caval vein

Eisenmenger Syndrome is a congenital heart defect that is associated with long-term elevated blood flow through the pulmonary vasculature, which tends to cause pulmonary hypertension and increasing pulmonary vascular resistance (D 'Alto, 2014). Moreover, this is a heart defect that causes a hole to develop between two chambers of the heart (D’Alto, 2014). The hole causes blood to circulate abnormally in the heart and lungs. Increased blood flow returns to your lungs instead of going to the rest of your body (D’Alto, 2014.) People with Eisenmenger 's syndrome commonly present with chronic cyanosis and progressive exercise intolerance. People with congenital heart diseases that have significant untreated left-to-right shunt lesions are at an increasing risk of developing pulmonary arterial hypertension (Kopeć et al., 2014).

Congenital heart diseases (CHDs) are the most prevalent of all birth defects and the leading cause of death in the first year of life, (1) with an annual prevalence ranging from six to twelve affected infants per 1,000 live births. (2)

Patent ductus arteriosus (PDA), one of the more common cardiac defects at birth, is the persistence of an opening between the pulmonary artery and the descending thoracic aorta. This opening is as a result of failure of the physiological fetus ductus arteriosus to close, which normally occurs soon after birth. This hole allows for oxygenated blood from the aorta to mix with oxygen-depleted blood from the pulmonary artery. As a consequence, significant strain is placed on the heart and pressure within the lungs’ arteries is dramatically increased.

The heart and great vessels are roughly in the middle of the thorax, being surrounded laterally and posteriorly by the lungs and anteriorly by the sternum and the central part of the thoracic cage. The heart acts a twofold, self-modifying suction and pressure pump, the parts of which work in union to push blood to all parts of the body. The right half of the heart (right heart) gets ineffectively oxygenated (venous) blood from the body via the SVC and IVC and pumps it through the pulmonary trunk to the lungs for oxygenation. The left half of the heart (left heart) gets well-oxygenated (arterial) blood from the lungs via the pulmonary veins and pushes it into the aorta for circulation to the body (Fig.1) (Moore and Dalley, 2006).