Assessment and treatment of post patent ductus arteriosus ligation syndrome

Afif F El-Khuffash; Amish Jain; Dany Weisz; Luc Mertens; Patrick J McNamara

doi:10.1016/j.jpeds.2014.03.048

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Assessment and treatment of post patent ductus arteriosus ligation syndrome

Journal article

Peer reviewed

Assessment and treatment of post patent ductus arteriosus ligation syndrome

Afif F El-Khuffash, Amish Jain, Dany Weisz, Luc Mertens and Patrick J McNamara

The Journal of pediatrics, Vol.165(1), pp.46-52.e1

07/2014

DOI: 10.1016/j.jpeds.2014.03.048

PMID: 24814414

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Abstract

To compare differences in tissue Doppler imaging, global longitudinal strain (GLS), and cardiac troponin T (cTnT) between infants with low (<200 mL/kg/min) and high (>200 mL/kg/min) left ventricular (LV) output 1 hour after duct ligation and assess the impact of milrinone treatment on cardiac output and myocardial performance. LV function was assessed preoperatively and 1 and 18 hours postoperatively. Infants were categorized into a low-output or a normal-output group based on the echocardiographic assessment of LV output at 1 hour. Thirty infants with a mean gestation of 25.3 weeks were enrolled. LV basal lateral S', basal septal S', and basal right ventricular S' were lower in the low-output group (n = 19) at 1 hour postoperatively, with no significant difference in GLS (low-output -10.3% vs high-output -14.4%, P >.05) or cTnT between the groups. Patients in the low-output group were treated with milrinone, and by 18 hours LV performance recovered to levels comparable with the high output group. cTnT values increased at 18 hours in the whole cohort with no significant difference between the groups. Tissue Doppler imaging and GLS provide novel insights and further characterization of myocardial performance immediately after patent ductus arteriosus ligation. A reduction in tissue Doppler-derived LV systolic velocity may further help in monitoring cardiac performance after patent ductus arteriosus ligation and for monitoring the effects of treatment.

Ductus Arteriosus, Patent - surgery

Cardiac Output - drug effects

Humans

Myocardial Contraction - physiology

Infant

Male

Treatment Outcome

Ligation - methods

Gestational Age

Cardiotonic Agents - therapeutic use

Troponin T - blood

Milrinone - therapeutic use

Echocardiography, Doppler

Female

Ventricular Function, Left - physiology

Ductus Arteriosus, Patent - physiopathology

Ductus Arteriosus, Patent - diagnostic imaging

Elasticity Imaging Techniques

Details

Title: Subtitle: Assessment and treatment of post patent ductus arteriosus ligation syndrome
Creators: Afif F El-Khuffash - Department of Pediatrics, The Rotunda Hospital, Dublin, Ireland
Amish Jain - Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada; Department of Physiology, University of Toronto, Toronto, Canada; Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Canada
Dany Weisz - Department of Pediatrics, Sunnybrook Health Sciences Centre, Toronto, Canada
Luc Mertens - The Labatt Family Heart Center, The Hospital for Children, Toronto, Canada
Patrick J McNamara - Department of Physiology, University of Toronto, Toronto, Canada; Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Canada; Department of Neonatology, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada. Electronic address: patrick.mcnamara@sickkids.ca
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.165(1), pp.46-52.e1
DOI: 10.1016/j.jpeds.2014.03.048
PMID: 24814414
ISSN: 0022-3476
eISSN: 1097-6833
Language: English
Date published: 07/2014
Academic Unit: Stead Family Department of Pediatrics; Neonatology; Internal Medicine
Record Identifier: 9984093606602771

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