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CTSU Presentation PDA
CTSU Presentation PDA
ARTERIOSUS
Dr. Amuda
Dr. Uwanduduru
Dr. Okon
Definition
Catheter trajectory:
• Catheter may easily pass
from PA to Ao through
the PDA.
• It gives a specific
appearance “Hair pin”
appearance.
• Oxymetry:
Steps up of O2 saturation in PA in comparison to RA.
• Pressure study:
RV & PA pressure is normal, but elevated in large PDA.
PVR is normal in infant & children but elevated in adult.
Complications:
• Injury to the recurrent laryngeal nerve
(hoarseness)
• The left phrenic nerve (paralysis of the left
hemidiaphragm)
• The thoracic duct (chylothorax) is possible.
• Recanalization (reopening) of the ductus is possible,
although rare, occurring after ligation alone (without
division).
Complications of PDA
The most common complications of PDA include
• CHF
• Infective endocarditis
• Pulmonary hypertension
Differential diagnosis
• VSD associated with aortic insufficiency
• Aortopulmonary window
• Pulmonary atresia with systemic collateral vessels
• Innocent venous hum
• Arteriovenous communications such as
• pulmonary arteriovenous fistula
• coronary artery fistula
• systemic arteriovenous fistula
• Ruptured sinus of Valsalva aneurysm
Reproductive Issues
• Pregnancy is well tolerated in women with silent
and small PDAs and in patients who were
asymptomatic before pregnancy.
• In women with a hemodynamically important PDA,
pregnancy may precipitate or worsen heart failure.
• Pregnancy is contraindicated in those with
Eisenmenger syndrome because of the high
maternal (≈50%) and fetal (≈60%) mortality.
References
●
Frank Netter Atlas of Human Anatomy
●
Schwartz Principles of Surgery
●
SRB’s manual of surgery
●
https://emedicine.medscape.com/article/891096-overview#:~:t
ext=The%20Krichenko%20classification%20of%20PDA%20is
%20based%20on,anatomy%20of%20the%20ductus%20may%
20not%20be%20present
●
https://radiopaedia.org/cases/krichenko-angiographic-
classification-of-patent-ductus-arteriosus-illustration?lang=us
Thank you