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Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease

Abstract

We report a case wherein a dysmorphic four-month-old infant (weighing 4.5 kgs) with an 8 mm atrial septal defect (ASD), a 1.5 mm patent ductus arteriosus (PDA), a 2 mm mid-muscular ventricular septal defect (VSD) associated with chronic lung disease, and severe pulmonary hypertension, was successfully managed using a hybrid approach, without the use of cardiopulmonary bypass (CPB). Through a median sternotomy, the PDA was ligated and the ASD was closed with a 9 mm Amplatzer septal occluder implanted through peratrial access. The VSD was left untouched. Serial echocardiograms showed complete closure of the ASD and PDA, with progressive normalization of the pulmonary artery (PA) pressures within three months. The child rapidly gained weight and was weaned from sildenafil and oxygen administration. After 12 months, the VSD closed spontaneously and the child remained well, with normal PA pressures. A hybrid approach without the use of CPB should be considered in the management of infants with congenital heart disease, associated with chronic lung disease and pulmonary hypertension.
Authors:
Pedra, Simone F; Jatene, Marcelo; Pedra, Carlos AC, E-mail: carlosacpedra@hotmail.com [1] 
  1. Hospital do Coração da Associação Sanatório Sírio, São Paulo (Brazil)
Publication Date:
Jan 01, 2010
Product Type:
Journal Article
Resource Relation:
Journal Name: Annals of pediatric cardiology; Journal Volume: 3; Journal Issue: 1; Other Information: PMCID: PMC2921521; PMID: 20814479; PUBLISHER-ID: APC-3-68; OAI: oai:pubmedcentral.nih.gov:2921521; Copyright (c) Annals of Pediatric Cardiology; This is an open-access article distributed under the terms of the Creative Commons Attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BYPASSES; CARDIOVASCULAR DISEASES; CLOSURES; CONGENITAL DISEASES; DEFECTS; HYBRIDIZATION; HYPERTENSION; INFANTS; LUNGS; MANAGEMENT; OXYGEN; SURGERY; WEIGHT
OSTI ID:
22343785
Country of Origin:
India
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0974-2069; TRN: IN15$0302050119
Availability:
Available from http://dx.doi.org/10.4103/0974-2069.64358; Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921521
Submitting Site:
INIS
Size:
page(s) 68-73
Announcement Date:
Jun 19, 2015

Citation Formats

Pedra, Simone F, Jatene, Marcelo, and Pedra, Carlos AC, E-mail: carlosacpedra@hotmail.com. Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease. India: N. p., 2010. Web. doi:10.4103/0974-2069.64358.
Pedra, Simone F, Jatene, Marcelo, & Pedra, Carlos AC, E-mail: carlosacpedra@hotmail.com. Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease. India. doi:10.4103/0974-2069.64358.
Pedra, Simone F, Jatene, Marcelo, and Pedra, Carlos AC, E-mail: carlosacpedra@hotmail.com. 2010. "Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease." India. doi:10.4103/0974-2069.64358. https://www.osti.gov/servlets/purl/10.4103/0974-2069.64358.
@misc{etde_22343785,
title = {Hybrid management of a large atrial septal defect and a patent ductus arteriosus in an infant with chronic lung disease}
author = {Pedra, Simone F, Jatene, Marcelo, and Pedra, Carlos AC, E-mail: carlosacpedra@hotmail.com}
abstractNote = {We report a case wherein a dysmorphic four-month-old infant (weighing 4.5 kgs) with an 8 mm atrial septal defect (ASD), a 1.5 mm patent ductus arteriosus (PDA), a 2 mm mid-muscular ventricular septal defect (VSD) associated with chronic lung disease, and severe pulmonary hypertension, was successfully managed using a hybrid approach, without the use of cardiopulmonary bypass (CPB). Through a median sternotomy, the PDA was ligated and the ASD was closed with a 9 mm Amplatzer septal occluder implanted through peratrial access. The VSD was left untouched. Serial echocardiograms showed complete closure of the ASD and PDA, with progressive normalization of the pulmonary artery (PA) pressures within three months. The child rapidly gained weight and was weaned from sildenafil and oxygen administration. After 12 months, the VSD closed spontaneously and the child remained well, with normal PA pressures. A hybrid approach without the use of CPB should be considered in the management of infants with congenital heart disease, associated with chronic lung disease and pulmonary hypertension.}
doi = {10.4103/0974-2069.64358}
journal = {Annals of pediatric cardiology}
issue = {1}
volume = {3}
journal type = {AC}
place = {India}
year = {2010}
month = {Jan}
}