动脉导管未闭（PDA）通过左侧开胸关闭

Patent Ductus Arteriosus (PDA) closure via Left Thoracotomy

A common congenital cardiac anomaly, Patent Ductus Arteriosus is often encountered by pediatricians, especially in premature infants. The ductus is a connection between Aorta and Pulmonary Artery which works as a outlet for blood flow to the legs and abdominal organs due to high resistance in the collapsed lungs in utero. When it remains open in spite of falling lung resistance after birth, it is termed PDA. If large the child will present with increased respiratory infections (due to increased blood flow), shortness of breath, enlarged heart (Left Ventricular volume overload), heart failure, failure to thrive i.e., lack of increase in body weight (due to heart failure). If it is persistent and not taken care of, it will result in a condition called Pulmonary Arterial Hypertension and within a few years the child will develop Eisenmenger's syndrome and will be inoperable. Treatment is simple, device closure is the norm, but sometimes due to very large and short ductus open surgery is preferable. In developing nations open surgery is still the most common approach. The following video is a demonstration to CTV surgeons in the procedure of PDA closure vila left thoracotomy. It is also to be reminded that PDA is sometimes necessary for certain conditions of the heart. Then it is called Ductal dependent circulation. Closing the ductus in those conditions will be disastrous. A thorough Echocardiographic evaluation to rule out other pathologies is essential.