Patent ductus arteriosus ACC/AHA guidelines
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
Overview
ACC/AHA recommendations regarding the evaluation and management of patient with a patent ductus arteriosus are found below.
ACC/AHA recommendations for patients with patent ductus arteriosus[1](DONOT EDIT)
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Recommendations for Evaluation of the Unoperated Patient Class I 1. Definitive diagnosis of patent ductus arteriosus (PDA) should be based on visualization by imaging techniques and demonstrations of the shunting across the defect (with or without evidence of clinically significant left ventricular [LV] volume overload). (Level of Evidence: C) Class III 1. Diagnostic cardiac catheterization is not indicated for uncomplicated PDA with adequate noninvasive imaging. (Level of Evidence: B) 2. Maximal exercise testing is not recommended in PDA with significant pulmonary arterial hypertension (PAH). (Level of Evidence: B) Management Strategies Recommendations for Medical Therapy Class I 1. Routine follow-up is recommended for patients with a small PDA without evidence of left-sided heart volume overload. Follow-up is recommended every 3 to 5 years for patients with a small PDA without evidence of left-heart volume overload. (Level of Evidence: C) Class III 1. Endocarditis prophylaxis is not recommended for those with a repaired PDA without residual shunt. (Level of Evidence: C) Recommendations for Closure of Patent Ductus Arteriosus Class I 1. Closure of a PDA either percutaneously or surgically is indicated for the following:
2. Consultation with adult congenital heart disease (ACHD) interventional cardiologists is recommended before surgical closure is selected as the method of repair for patients with a calcified PDA. (Level of Evidence: C) 3. Surgical repair by a surgeon experienced in CHD surgery is recommended when:
Class IIa 1. It is reasonable to close an asymptomatic small PDA by catheter device. (Level of Evidence: C) 2. PDA closure is reasonable for patients with PAH with a net left-to-right shunt. (Level of Evidence: C) Class III 1. PDA closure is not indicated for patients with PAH and net right-to-left shunt. (Level of Evidence: C) |
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References
- ↑ Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.
External links
- Fetal Circulation at berkeley.edu
- Information about PDA - The Hospital for Sick Children
- Goldminer: Patent ductus arteriosus