Surgical Interruption of Patent Ductus Arteriosus in a Child With Severe Aortic Stenosis: Anesthetic Considerations

Abstract

PATENT DUCTUS ARTERIOSUS (PDA) is among the most common congenital heart diseases 1 Schwartz A.J. Campbell F.W. Pathophysiological approach to congenital heart disease. in: Lake C.L. Pediatric Cardiac Anesthesia. Appleton and Lange, Stamford, CT1998: 7-20 Google Scholar and is often associated with other cardiac defects (eg, ventricular septal defect, tetralogy of Fallot, transposition of great arteries). Early series of children requiring repair of PDA reported an incidence of clinical aortic stenosis (AS) of 3% to 10%. 2 Bonham-Carter R.E. Walker C.H.M. Matthews M.B. et al. Patent ductus arteriosus with an abnormal aortic valve. Br Heart J. 1955; 17: 255-261 Crossref PubMed Scopus (4) Google Scholar The treatment options for PDA include surgical interruption, video-assisted thoracoscopic surgical clipping, 3 Laborde F. Folliguet T. Batisse A. et al. Video-assisted thoracoscopic surgical interruption: The technique of choice for patent ductus arteriosus. Routine experience in 230 pediatric cases. J Thorac Cardiovasc Surg. 1995; 110: 1681-1685 Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar and coil embolization or device closure of the PDA in the catheterization laboratory. 4 Rosen D.A. Rosen K.R. Anomalies of the aortic arch and valve. in: Lake C.L. Pediatric Cardiac Anesthesia. Appleton and Lange, Stamford, CT1998: 431-489 Google Scholar The presence of severe AS can adversely affect the intraoperative course in a patient undergoing surgical interruption of PDA. A patient is described in whom surgical interruption of PDA was done in the presence of severe AS.