EG: LAD, LAH, LVH, BVH if PH CL: RRTI, CHF (large PDA), FT, Normal functionally clossure 10 -15

Normal functionally clossure 10 -15 hrs If not close: CHF (large

Tachypnoe, Pulsus Celler, P2 ↑ if HP, PDA), Endarteritis ⇒
RO: Cardiomegali due to LAH &LVH,
Ao >, PA>, Phletora.Pruned tree if PVD continuous/machinary murmur ICS2 PDA affter birth & Anatomically clossure as
ligamentum arteriosum at 2 – 3 wk endokarditis.
due to PH. LSB radiate to below left clavicle, DD: A-P Window, A-V coronary fistel, VSD
MM: LA dilatation, LV dilatation Diastolic murmur ↓ / disapear if PH. & AR, AS & AR,
2D: PLX high view Or suprasternal.
CD: Shunt direction: continue L-R at Only in PH, suspecte
sistole & diastol, L-R at sistole & R-L at other anatomical defect,
Ductal diameter (mm)/diameter of
diastole in PH. PG PA=Ao throgh PDA. evaluation for ADO or
the ostium of the left PA (mm):
NEONATE / - Small: <0.5 CHILD / coil.
O2 step up at PA, ↑ PAP
Corect general condition, hypoglicemia
& hypocalsemia (frequent in premature,
INFANT - Moderate: >0.5 to 1
- Large: >1
ADULT & RVP if PH, asess PAP
at closing PDA with
that worse myocard), digitalis, diuretic
baloon cath until no
& vasodilator.
shunt, PARi, O2 100 %
test
Avoid diuretic & vasodilator Ao arc- graphy: evaluate
because inhibit spontan PDA CHF(+) CHF (-) PH (-) PH (+) anatomi & PDA size.
clossure LV-graphy (if needed):
asess LV function &
other anomaly

Pre Term At Term

L→R L↔R
In Preterm & age < 10 d,
dosis 0,2 mg/kg BW 3 X,
interval 12 hrs IV/PO. Repeat
if fail. Contra indication: ↓
renal, liver function, ICH, GI-
bleeding, NEC, sepsis.
Cath
MEDICAMENTOSA + MEDICAMENTOSA
INDOMETACHIN
& without FT
⇒ elective
without cath

Response Response Response Response Reactive Non

(+) (-) (-) (+) reactive

Urgent Age 12-16 Age 12- at occlusion PDA

wk 16 wk with baloon cath, If
Pari < 8 U/m2 or
PARi > 8 U/m2 & ↓
~ Criteria, with O2 test
contra
indicated in
PH

SPONTAN PDA-LIGATION ( ADO/COIL/SURGICAL) or PDA-TOMI CONSERVATIVE

CLOSSURE