Transcatheter Closure of a Residual Patent Ductus Arteriosus After Surgical Ligation in Children

BACKGROUND AND OBJECTIVES: To assess the safety and efficacy of transcatheter closure of residual ductal flow after initial surgical ligation of the arterial duct. SUBJECTS AND METHODS: Between June 2005 and December 2009, transcatheter occlusion of residual postsurgical ductus arteriosus was performed in six children. RESULTS: The mean patient age was 10+/-5.5 years; mean post-procedural time since the initial surgical closure was 6.3+/-4.5 years. The mean diameter of the patent ductus arteriosus on angiography was 1.3+/-0.5 mm (range, 0.8 to 2.4 mm). Three different types of coils were used successfully without any complications. CONCLUSION: Transcatheter occlusion of residual postsurgical arterial duct is a safe and successful procedure. However, attention should be paid due to the distorting shape of the arterial duct.

Effect of mode of delivery on postnatal decline in pulmonary artery pressure

To evaluate the effect of the mode of delivery on the course of pulmonary artery pressure [PAP] in neonates. Eighty healthy and term neonates delivered in the maternity wards of Dunya Maternity Hospital, Camlica Maternity Center, and Sultan Maternity Hospital in Diyarbakir, Turkey from June to August 2009 were included in the study. Tricuspid regurgitation [TR] was determined using color Doppler echocardiography, and the measurements were carried out with continuous wave technique on the first, third, and the fifth days of birth. The babies who had no TR flow on the first, third, or the fifth day were excluded, and the study was completed with 42 cases. Twenty-two of them were delivered by cesarean section [CS], and 20 by vaginal delivery. The peak flow velocity of TR was used in the calculation of the right ventricular pressure, which reflects PAP. In both groups, PAP continued to decline on the third and fifth days. However, in the vaginal delivery group, the decrease between the third and fifth days was statistically insignificant, whereas a statistically significant decline [p=0.01] in the CS group lasted until the fifth day. Although the birth method does not create a clinical morbidity on the circulatory system as seen in the respiratory system, it can be stated that the circulatory adaptation of vaginally delivered babies is completed earlier

Echocardiographic study of aortic root diameter in healthy children

Objectives:Echocardiography is commonly used to measure the internal diameter of aortic root, which provides the evaluation of aortic root dilatation. Aortic root dilatation provide information concerning prognosis of aortic regurgitation and predisposition to aortic root dissection or rupture. The purpose of the study was to create normal values for aortic root diameters by using echocardiography in healthy children.Methods:We obtained the aortic root diameters in 229 normal children, aged one day to 15 years by using M-mode echocardiography. We performed the echocardiograms from the Department of Pediatric Echocardiography Laboratory, Medical Faculty, Dicle University, Turkey. We divided the children into 6 groups according to their body surface area [BSA]: 0.20-0.25 m2, 0.25-0.50 m2, 0.50-0.75 m2, 0.75-1.0 m2, 1.0-1.25 m2, and 1.25-1.50 m2. We corrected the aortic root diameters for BSA.Results:The aortic root diameters in children were 7.6 mm to 24 mm with a mean value of 14.8 mm. The corrected aortic root diameter for BSA ranged from 10.7 to 40.6 mm/m2 with a mean value of 19.9 mm/m2. Aortic root diameters increased with age, weight and BSA. In contrast, aortic root diameter/BSA values were higher in younger children.Conclusion:The presented aortic root diameters according to the BSA will serve as reference data for echocardiographic evaluation of patients with various cardiac diseases