Patent Ductus Arteriosus with Pulmonary Hypertension: Temporary Obstruction of the Ductus During Cardiac Catheterization to Evaluate Indication for Surgical Closure

Abstract

In patent ductus arteriosus with pulmonary hypertension and partial reversal of the shunt, the outcome of the surgical closure of the ductus depends on the direction of the major shunt and on the behavior of the pulmonary artery pressure following closure. Calculation of the shunts in the presence of bidirectional flow through the patent ductus is inaccurate using ordinary means. This report illustrates the possibility of prediction of the changes in pulmonary artery pressure and of a more accurate calculation of the shunts without surgical exploration. The ductus can be occluded during cardiac catheterization by a special three-way catheter with an inflatable balloon attachment which is placed into the patent ductus. The danger of the procedure does not exceed that of the usual cardiac catheterization and prevents the performance of an unnecessary thoracotomy.