International Medical Journal, Vol. 24., Iss. 2, 2018, P. 29−34.
MODERN VIEW ON THE PROBLEMATIC ASPECTS OF PATENT ARTERIAL DUCT IN CHILDREN (literature review)
V. T. Zaitsev Institute of General and Urgent Surgery of AMS of Ukraine, Kharkiv, Ukraine
The review of the literature is devoted to one of the most important directions of modern surgery, the problem of patent arterial duct in children of different age groups. Patent arterial duct is one of the most common congenital malformations of the cardiovascular system, which can occur both as an isolated pathology, and as combination with other heart and vessel defects. Its functioning can both aggravate the course of concomitant pathology and compensate complications which appeared as its result. The review of literature data, existing terminology, classification of patent arterial duct, diagnostic criteria of hemodynamically significant patent arterial duct are presented. Echocardiographic diagnostic criteria are described in detail. The modern approaches to the treatment of patent arterial duct, including conservative, (pharmacological with the use of nonselective inhibitors of cyclooxygenase −− indomethacin, ibuprofen) and various surgical methods are elucidated. It is necessary to note that there are no unified approaches for terminology defining patent arterial duct functioning in the national medical literature, and a number of different terms are used in various sources. The exact frequency of the defect occurrence is unknown; there is no unified classification of patent arterial duct. The study of markers of hemodinamically significant patent arterial duct was carried out mainly in premature newborns or newborns with low birth weight. But study of the signs of hemodynamically significant patent arterial duct has particular priority for improvement of survival, quality of life and prevention of complications development and early disability not only in extremely premature newborns, but also in children of different age groups. Up to date, there are no unified diagnostic and therapeutic approaches to patent arterial duct both in preterm infants and in children of different age groups. Thus, it is necessary to pay more attention to the ways of solving the problem of this pathology with a view to further developing the diagnostic criteria, which will promote effective treatment of children of different ages with this congenital malformation.
Key words: patent arterial duct, hemodynamically significant criteria, echocardiographic signs.