ACC/AHA recommendations for closure of patent ductus arteriosus: Difference between revisions
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{{Patent ductus arteriosus}} | {{Patent ductus arteriosus}} | ||
{{CMG}}; '''Associate Editor-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto: | {{CMG}}; '''Associate Editor-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com], {{CZ}}; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | ||
==Overview== | ==Overview== | ||
The decision for closure of patent ductus arteriosus depends on the size of ductus, presence of left or right ventricular hypertrophy and pulmonary arterial hypertension. It is contraindicated in patients with eisenmenger's syndrome and right-to-left shunt. | The decision for closure of patent ductus arteriosus depends on the size of ductus, presence of left or right ventricular hypertrophy and pulmonary arterial hypertension. It is contraindicated in patients with eisenmenger's syndrome and right-to-left shunt. | ||
==ACC/AHA recommendations for closure in patients with patent ductus arteriosus<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=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. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref> | ==ACC/AHA recommendations for closure in patients with patent ductus arteriosus(DONOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=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. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref>== | ||
{| class="wikitable" | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Closure of a PDA either percutaneously or surgically is indicated for the following: | |||
::'''1.''' Left atrial and/or LV enlargement or if PAH is present, or in the presence of net left-to-right shunting.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
''' | |||
::'''2.''' Prior endarteritis.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
::'''2.''' Prior endarteritis. (Level of Evidence | |||
''' | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''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. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
''' | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Surgical repair by a surgeon experienced in CHD surgery is recommended when: | |||
'''1.''' | ::'''1.''' The PDA is too large for device closure.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | ||
''' | ::'''2.''' Distorted ductal anatomy precludes device closure (e.g., aneurysm or endarteritis). (Deanfield et al., 2003)''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|} | |||
'''1.''' PDA closure is not indicated for patients with PAH and net right-to-left shunt. (Level of Evidence: C) | {| class="wikitable" | ||
}} | |- | ||
| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] | |||
|- | |||
| bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' PDA closure is not indicated for patients with PAH and net right-to-left shunt.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
|} | |||
{| class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |||
|- | |||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to close an asymptomatic small PDA by catheter device. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' PDA closure is reasonable for patients with PAH with a net left-to-right shunt. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|} | |||
==References== | ==References== | ||
{{reflist}} | {{reflist|2}} | ||
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{{WS}} | |||
[[CME Category::Cardiology]] | |||
[[Category:Disease]] | |||
[[Category:Disease | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Congenital heart disease]] | [[Category:Congenital heart disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
Latest revision as of 19:03, 14 March 2016
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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
The decision for closure of patent ductus arteriosus depends on the size of ductus, presence of left or right ventricular hypertrophy and pulmonary arterial hypertension. It is contraindicated in patients with eisenmenger's syndrome and right-to-left shunt.
ACC/AHA recommendations for closure in patients with patent ductus arteriosus(DONOT EDIT)[1]
| 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 III |
| "1. PDA closure is not indicated for patients with PAH and net right-to-left shunt.(Level of Evidence: C) " |
| 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)" |
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.