RESUMEN
Anatomists since antiquity and pathologists since at least the 17th century had identified the ductus arteriosus (DA) in cadavers and postmortem examinations, respectively. However, healthcare providers for more than a century have struggled to understand the significance of a patent ductus arteriosus (PDA) in patients, debated whether to treat it or not and if so, when and how. Accepted answers depended upon the authoritative position of the person(s) offering recommendations, the cumulative contemporary medical knowledge, and the changing patient population characteristics. The treatment choices were most often based on one's understanding of the balance between the risks and benefits of the chosen treatment. In the current era, with the increasing popularity of transcatheter occlusion of the PDA with relative ease even in extremely premature infants whose survival rates have improved dramatically, a basic question has reemerged-what are the benefits to treating the PDA in any preterm infant. In this brief review, I am providing a chronicle of the evolution of knowledge about the DA, the varying nature of the challenges a patent ductus posed for the caregivers, and the roots of the continued debate concerning the management of the enigmatic PDA.
Asunto(s)
Conducto Arterioso Permeable/historia , Conducto Arterioso Permeable/terapia , Conducto Arterioso Permeable/diagnóstico , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Recien Nacido Extremadamente Prematuro , Recién NacidoAsunto(s)
Conducto Arterioso Permeable/diagnóstico , Conducto Arterioso Permeable/historia , Conducto Arterial/anatomía & histología , Perinatología/historia , Procedimientos Quirúrgicos Cardiovasculares , Conducto Arterial/fisiopatología , Conducto Arterioso Permeable/fisiopatología , Historia del Siglo XV , Historia del Siglo XX , Historia Antigua , Humanos , Recién Nacido , Recien Nacido PrematuroRESUMEN
Despite a large body of scientific evidence on the management of premature infants with a patent ductus arteriosus controversy remains and neonatologists remain challenged for knowing which patient to treat, what is the most optimal timing of treatment and which treatments have a positive impact on both short-term and long-term outcomes. In this review article we discuss the increased body of evidence over the past 10â years, much of which questions the role of treatment and suggests the need to reconsider how haemodynamic significance is adjudicated. In addition, we discuss novel approaches to assessment and diagnosis, and highlight areas for future investigation.
Asunto(s)
Conducto Arterioso Permeable , Conducto Arterioso Permeable/diagnóstico , Conducto Arterioso Permeable/historia , Conducto Arterioso Permeable/fisiopatología , Conducto Arterioso Permeable/cirugía , Hemodinámica , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Recién Nacido , Recien Nacido PrematuroRESUMEN
BACKGROUND: Henry Barrett worked as a general surgeon in New Plymouth, New Zealand between 1939 and 1978. In this time, he made significant contributions to the development of paediatric surgery in New Zealand. METHODS: Henry Barrett's archive and personal papers remain in the possession of his family. These described his pioneering operations first hand. RESULTS: In an 18-month period from 1947 to 1948, in New Plymouth small provincial hospital, Henry Barrett successfully completed the first primary repair of an oesophageal atresia with distal tracheoesophageal fistula in the Southern Hemisphere and the second and third successful ligations of patent ductus arteriosus in New Zealand. All three patients survived into adulthood. CONCLUSION: Henry Barrett pioneered the undertaking of two complex paediatric surgical procedures in New Zealand. These operations were performed without specialist paediatric support at a time when procedures for these conditions, particularly patent ductus arteriosus, were viewed with suspicion.
Asunto(s)
Pediatría/historia , Especialidades Quirúrgicas/historia , Conducto Arterioso Permeable/historia , Conducto Arterioso Permeable/cirugía , Atresia Esofágica/historia , Atresia Esofágica/cirugía , Historia del Siglo XX , Humanos , Nueva Zelanda , Fístula Traqueoesofágica/historia , Fístula Traqueoesofágica/cirugíaRESUMEN
This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques.
Asunto(s)
Cateterismo Cardíaco , Conducto Arterioso Permeable/terapia , Cateterismo Cardíaco/historia , Cateterismo Cardíaco/instrumentación , Cateterismo Cardíaco/tendencias , Difusión de Innovaciones , Conducto Arterioso Permeable/diagnóstico , Conducto Arterioso Permeable/historia , Conducto Arterioso Permeable/fisiopatología , Diseño de Equipo , Predicción , Hemodinámica , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Resultado del TratamientoRESUMEN
Seventy-five years ago, a 7-year-old girl underwent the first successful ligation of a patent ductus arteriosus. This procedure transformed her health and was a milestone in the development of cardiac surgery. The operation was performed by Dr. Robert E. Gross, then the surgical chief resident at Boston Children's Hospital, who went on to have a distinguished career in pediatric surgery. The patient is now a great-grandmother and the oldest known survivor of cardiac surgery.
Asunto(s)
Conducto Arterioso Permeable/historia , Cirugía Torácica/historia , Anestesia por Inhalación/historia , Anestésicos por Inhalación , Ciclopropanos , Conducto Arterioso Permeable/cirugía , Femenino , Historia del Siglo XX , Humanos , Recién Nacido , Estados UnidosAsunto(s)
Sociedades Médicas/historia , Cirugía Torácica/historia , Procedimientos Quirúrgicos Torácicos/historia , Investigación Biomédica/historia , Conducto Arterioso Permeable/historia , Conducto Arterioso Permeable/cirugía , Educación Médica/historia , Historia del Siglo XX , Humanos , Estados UnidosAsunto(s)
Fármacos Cardiovasculares/uso terapéutico , Conducto Arterioso Permeable/fisiopatología , Indometacina/uso terapéutico , Conducto Arterioso Permeable/embriología , Conducto Arterioso Permeable/historia , Conducto Arterioso Permeable/terapia , Ecocardiografía/métodos , Femenino , Historia del Siglo XVI , Historia del Siglo XVII , Historia del Siglo XXI , Historia Antigua , Humanos , EmbarazoRESUMEN
By 1769, it was known to Morgagni that the ductus arteriosus may persist until adulthood. In 1835, Jörg linked delayed postnatal closure with disturbed respiration, a discovery that was afterwards forgotten for a century. When blood gas analysis became available, the association between persisting patency and diminished oxygenation resurfaced. When it became known that prostaglandins played a role in maintaining ductal patency, the development of pharmacologic intervention with cyclooxygenase inhibitors immediately followed. This rapid progress was due to the interaction between basic science, pediatric cardiology, and neonatology disciplines at the Cardiovascular Research Institute in San Francisco, coordinated by Julius Comroe, as well as President Kennedy's foundation of the National Institute of Child Health and Development. This series of events exemplifies how clinical research became an integrated managed multidisciplinary endeavor in the 20th century.
Asunto(s)
Conducto Arterioso Permeable/historia , Conducto Arterioso Permeable/metabolismo , Conducto Arterioso Permeable/terapia , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Recién Nacido , Recien Nacido Prematuro , Síndrome de Dificultad Respiratoria del Recién Nacido/historiaRESUMEN
Congenital heart disease began to be a treatable condition when, in 1938, Robert Edward Gross first successfully ligated a persistent ductus arteriosus. This overview traces the historical development from Munro's first idea of how to close a patent ductus, presented in 1907, to the clinical ligation or division of the ductus. Surgical treatment of the infected ductus began with an unsuccessful attempt by Strieder, but it was not until Tubbs' and Touroff's successful operations that it was actually accomplished.
Asunto(s)
Conducto Arterioso Permeable/historia , Cirugía Torácica Asistida por Video/historia , Conducto Arterioso Permeable/cirugía , Historia del Siglo XVI , Historia del Siglo XVII , Historia del Siglo XIX , Historia del Siglo XX , HumanosRESUMEN
The conventional surgical history of ligation of a patent ductus arteriosus (PDA) dates from August 26, 1938, when Robert E. Gross of Boston, Massachusetts, successfully ligated a PDA. It is largely unknown that in the same year and before Gross, Emil Karl Frey, a Surgeon at the Medizinische Akademie in Dusseldorf, Germany, already ligated a PDA successfully. Assuming that he would soon perform more ligations, Frey did not publish his findings, and this historic ductal operation escaped attention.