Rational choice of treatment for arterial catheterization

  1, the automatic closure of the ductus arteriosus: The ductus arteriosus is a normal blood flow pathway connecting the body and pulmonary circulation (aorta-pulmonary artery) that existed before the baby was born, the vast majority of which can be closed within 2-3 weeks after birth; the remaining few can be closed within 8 months after birth; those who have not been closed for more than 1 year will generally not close naturally. Of course, there are exceptions.  2, does not necessarily require treatment of the arteriovenous catheter: For ultrasound measurement of the diameter of the arteriovenous catheter is less than 2mm, the auscultation murmur is not obvious, suggesting that the fractional flow is very small, belong to the “silent” arteriovenous catheter, will not have a negative impact on the child, can not require treatment; and for the auscultation is not continuous murmur, but the auscultation systolic If the murmur is not continuous on auscultation, but the systolic murmur is obvious on auscultation, and there is no change in follow-up for more than 1 year, it means that there is still considerable fractional flow, and treatment needs to be considered as appropriate.  3, drugs to close the ductus arteriosus: generally applicable to premature infants with ductus arteriosus.  The effect of application for full-term infants is generally poor.  4.Special cases that need to keep the arterial duct open: Some complex congenital heart malformations need to rely on the arterial duct open to keep the child alive, such as pulmonary atresia or severe pulmonary artery stenosis. Drugs (prostaglandins) or interventional stents can be used to keep the arterial duct open.  Interventional treatment: All types of ductus arteriosus, except window ductus arteriosus, can be treated with cardiac catheterization.  Generally, it requires an age of 6 months or older and a weight of more than 8 kg; special cases of 4-8 kg are also possible.  The price is slightly higher than surgical procedures, usually between $15,000 and $20,000.  The disadvantage is that it is radioactive (equivalent to 1 CT scan).  6.Surgical treatment: Applicable to all types of ductus arteriosus, no extracorporeal circulation is required.  The price is slightly lower than catheter intervention, usually between $10,000 and $15,000.  The disadvantage is that it is still somewhat invasive.