Cheng C F, Wu M H, Wang J K
Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Int J Cardiol. 1995 May;49(3):209-12; discussion 212-3. doi: 10.1016/0167-5273(95)02289-9.
A 20 days old female baby presenting with dyspnea was found to have coarctation of the aorta and patent ductus arteriosus by echocardiography. The Doppler spectral display disclosed mainly a left-to-right shunt through the ductus. Therefore, the prostaglandin El infusion was discontinued. She developed acute left heart failure, and the echocardiograms at that time showed a markedly narrowed juxtaductal aortic coarctation with a closed ductus. After resumption of prostaglandin El, with an attenuated juxtaductal aortic coarctation, the left ventricular contractility and the systemic perfusion improved. Therefore, we conclude that the central role of a patent ductus in such a patient is to avoid the ductal constriction which will worsen the aortic coarctation.
一名20日龄出现呼吸困难的女婴经超声心动图检查发现患有主动脉缩窄和动脉导管未闭。多普勒频谱显示主要为经动脉导管的左向右分流。因此，停止输注前列腺素E1。她出现了急性左心衰竭，此时的超声心动图显示动脉导管旁主动脉缩窄明显变窄，动脉导管闭合。重新输注前列腺素E1后，动脉导管旁主动脉缩窄减轻，左心室收缩力和体循环灌注得到改善。因此，我们得出结论，动脉导管未闭在这类患者中的核心作用是避免导管狭窄，否则会加重主动脉缩窄。
