Bamigboye-Taiwo O T, Okeniyi J A, Onakpoya U U, Ojo O O, Eyekpegha J O, Oguns A, Adeyefa B
Paediatric Cardiology Unit, Department of Paediatrics, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
West Afr J Med. 2020 Jan-Mar;37(1):58-61.
Transthoracic open surgical ligation (TTOSL) of patent ductus arteriosus (PDA) remains the most readily available and affordable treatment option in resource-poor countries such as Nigeria.
To determine the incidence and outcome of aortic valve regurgitation (AR) following TTOSL of PDA.
Retrospective audit of consecutive patients who underwent TTOSL of PDA over a 4½-year period (January 2015 to June 2019) at the OAUTHC, Ile-Ife, Nigeria. Hospital records including echocardiograms (pre-operative, immediate post-operative and follow-up performed a day after TTOSL, at 1, 3 and 12 months) were reviewed for presence and severity of AR.
Twenty-six patients (11 males and 15 females) aged 3 months 24 years (Mean = 3.16 years) had TTOS PDA ligation. Only 3 (11.5%) patients had AR pre-operatively; 2 graded moderate AR and 1 graded mild. Twenty (76.9 %) patients had immediate post-operative AR; 4 (20.0%) of which were moderate and the others (80.0%) were mild. Eighteen (69.2%) patients still had AR post-operative day 1; 16 were mild and the rest 2 which were moderate were the same patients that had AR pre-operatively. At 3 months follow-up, 6 of 20 patients (30.0%) had AR; all were mild. Only 2 of 18 (11.1%) followed up for 12 months had AR. They both had had moderate AR pre-operatively which were now graded as mild. There was no mortality.
Aortic regurgitation is common after TTOSL of PDA. However, in most instances, it is mild and transient.
在尼日利亚等资源匮乏的国家，经胸开放性手术结扎动脉导管未闭（PDA）仍是最容易获得且负担得起的治疗选择。
确定PDA经胸开放性手术结扎术后主动脉瓣反流（AR）的发生率及结局。
对2015年1月至2019年6月在尼日利亚伊费奥奥塔乌瑟大学教学医院（OAUTHC）接受PDA经胸开放性手术结扎的连续患者进行回顾性审计。查阅医院记录，包括超声心动图（术前、术后即刻以及在PDA经胸开放性手术结扎术后第1天、1个月、3个月和12个月进行的随访），以了解AR的存在情况及严重程度。
26例患者（11例男性和15例女性），年龄3个月至24岁（平均 = 3.16岁）接受了PDA经胸开放性手术结扎。术前仅3例（11.5%）患者存在AR；2例为中度AR，1例为轻度。20例（76.9%）患者术后即刻出现AR；其中4例（20.0%）为中度，其余（80.0%）为轻度。18例（69.2%）患者术后第1天仍存在AR；16例为轻度，其余2例为中度，这2例中度AR患者与术前存在AR的患者相同。在3个月随访时，20例患者中有6例（30.0%）存在AR；均为轻度。在18例接受12个月随访的患者中，仅有2例（11.1%）存在AR。他们术前均为中度AR，现在分级为轻度。无死亡病例。
PDA经胸开放性手术结扎术后主动脉瓣反流很常见。然而，在大多数情况下，它是轻度且短暂的。
