Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider.
Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider.
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DOI：
10.1161/jaha.122.025784
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发表时间：
2022-09-06
影响因子：
5.4
通讯作者：
Garg, Vidu
中科院分区：
文献类型：
--
作者：
Backes, Carl H.;Hill, Kevin D.;Shelton, Elaine L.;Slaughter, Jonathan L.;Lewis, Tamorah R.;Weisz, Dany E.;Mah, May Ling;Bhombal, Shazia;Smith, Charles, V;McNamara, Patrick J.;Benitz, William E.;Garg, Vidu
动脉导管未闭(PDA)的负担仍然很大。鉴于早产儿与更成熟的足月儿的显著差异(从青少年和成年患者的连续统一体来看)，在适当的情况下，单独讨论调节导管通畅的机制、遗传贡献、临床后果以及诊断和治疗阈值。在早产儿和年龄较大的儿童和成人中，都提供了一系列血流动力学特征，强调了PDA的显著不同后果。在大多数当代环境中，经导管封堵术比外科结扎术更可取，但缺乏关于长期结果的数据，特别是在早产儿中。本综述提供了识别PDA诊断、管理和治疗方面的差距的建议，后续研究可以在此基础上开展。归根结底，完善的诊断阈值和扩大的治疗选择相结合，提供了解决PDA负担的最佳机会。尽管基本的差距仍未得到解决，但本综述为儿科和成人心脏护理提供者提供了PDA护理的当代框架，以支持循证医学的实践。
The burden of patent ductus arteriosus (PDA) continues to be significant. In view of marked differences in preterm infants versus more mature, term counterparts (viewed on a continuum with adolescent and adult patients), mechanisms regulating ductal patency, genetic contributions, clinical consequences, and diagnostic and treatment thresholds are discussed separately, when appropriate. Among both preterm infants and older children and adults, a range of hemodynamic profiles highlighting the markedly variable consequences of the PDA are provided. In most contemporary settings, transcatheter closure is preferable over surgical ligation, but data on longer‐term outcomes, particularly among preterm infants, are lacking. The present review provides recommendations to identify gaps in PDA diagnosis, management, and treatment on which subsequent research can be developed. Ultimately, the combination of refined diagnostic thresholds and expanded treatment options provides the best opportunities to address the burden of PDA. Although fundamental gaps remain unanswered, the present review provides pediatric and adult cardiac care providers with a contemporary framework in PDA care to support the practice of evidence‐based medicine.
影响因子：
2.6
作者：
Yang MC;Liu HK;Wu HY;Tey SL;Yang YN;Wu CY;Wu JR
通讯作者：
Wu JR