An attempt to obliterate the patent ductus arteriosus in a patient with subacute bacterial endarteritis

Graybiel, Ashton; Strieder, John W.; Boyer, Norman H.

doi:10.1016/s0002-8703(38)90564-2

Cited by 81 publications

(18 citation statements)

References 2 publications

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“…Although Gibson, in 1898, had clearly described the characteristic murmur of the patent ductus arteriosus and emphasized its diagnostic significance (Gibson, 1900), it was not until 1937 that Strieder made the first attempt to close a patent ductuis arteriosus. The closure was incomplete and the patient died (Graybiel, Strieder, and Boyer, 1938).…”

mentioning

confidence: 99%

Patent ductus arteriosus in infants and children: A review of 936 operations (1946-69)

Panagopoulos

Tatooles

Aberdeen

et al. 1971

Thorax

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mentioning

confidence: 99%

Patent ductus arteriosus in infants and children: A review of 936 operations (1946-69)

Panagopoulos

Tatooles

Aberdeen

et al. 1971

Thorax

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“…i . , i 1 i + i ; i ; g 1 ; r | S i , ;,* i j PATENT DUCTUS ARTERIOSUS first successful ligation being reported by Gross and Hubbard (1939). The details of the Gross technique (1939a, 1939b) have been modified slightly, Touroff (1942a) in particular emphasizing the great advantages of subadventitial dissection on the arch of the aorta.…”

Section: The Objects Of Surgical Ligationmentioning

confidence: 99%

Patent Ductus Arteriosus and Its Surgical Treatment

1945

Heart

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The remarkable success that has attended surgical ligation of the patent ductus arteriosus has aroused a new interest in a unique structure and has been the means of revealing striking gaps in our knowledge-of a comparatively common form of congenital heart disease. Unexpectedly , ligation of the infected ductus has shed a new light on the most serious of all forms of heart disease-bacterial endocarditis. Of vital importance in intra-uterine life, during which its purpose is to enable venous blood entering the heart from the superior vena cava to pass directly to the descending aorta and thence to the placenta without traversing the lungs (Barcroft, 1939), the arterial duct persisting after birth forms an arterio-venous fistula. Blood then flows continuously' in large quantities from the aorta to the pulmonary artery. Hence the patent ductus throws an added burden upon the heart and upon the pulmonary and to some extent the peripheral circulations. PROBLEMS OF THE PATENT DUCTUS Despite the enormous literature that has accumulated on this branch of congenital heart disease, we have not yet adequate solutions for many of the most fundamental of its problems. Theories and suggestions to account for the closure of the ductus are many, but the factors determining the natural process of occlusion, or permitting the persistence of the channel for months or years or throughout life, are mysteries for which so far we have no entirely satisfactory explanations. Wells (1908) and Abbot (1927) have summarized the more important suggestions advanced to account for the mechanism of closure, none of which in the light of present day knowledge can be regarded as adequate without experimental proof. Expansion of the bronchi compressing the ductus, inflation of the lungs with consequent readjustment of the thoracic viscera leading to stretching and obliteration of the ductus, local thrombosis within the duct as a result of changes in blood pressure in the two circuits, the occlusive effect of a valve-like fold of aortic endothelium overlying the orifice of the channel, the constrictive effect of the recurrent laryngeal nerve as the viscera sink lower in the thorax, are among the possibilities which in the past have been advanced and seriously considered by various authors. Kennedy and Clark (1942) and Kennedy (1942) have demonstrated that during late fcetal life the ductus arteriosus is an active structure, responsive to certain stimuli of which at least one favouring its prompt closure is, they believe, a rich oxygen supply either by inhalation or intravenously. By the injection of radio-opaque dye into the blood stream of foetal lambs delivered by Caesarean section, Barcroft and his collaborators (1938, 1939, 1941) have clearly demonstrated abrupt changes in the patency of the ductus so that functionally there is a rapid obliteration of its lumen even within five minutes of birth. Anatomical obliteration is a gradual process. The factors initiating the functional or primary closure, maintaining the muscular contraction of the du...

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“…The first attempt by Graybiel and Strieder (1938) PATENT DUCTUS ARTERIOSUS first successful ligation being reported by Gross and Hubbard (1939). The details of the Gross technique (1939a, 1939b) have been modified slightly, Touroff (1942a) in particular emphasizing the great advantages of subadventitial dissection on the arch of the aorta.…”

Section: The Objects Of Surgical Ligationmentioning

confidence: 99%

“…The speed with which a child under 10 will rally after ductal ligation is remarkable. Gross (1939) has had children out of bed 24 hours after operation and ambulatory on the third day.…”

Section: The Indications For Surgerymentioning

confidence: 99%

Patent ductus arteriosus and its surgical treatment

1945

American Heart Journal

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An attempt to obliterate the patent ductus arteriosus in a patient with subacute bacterial endarteritis

Cited by 81 publications

References 2 publications

Patent ductus arteriosus in infants and children: A review of 936 operations (1946-69)

Patent ductus arteriosus in infants and children: A review of 936 operations (1946-69)

Patent Ductus Arteriosus and Its Surgical Treatment

Patent ductus arteriosus and its surgical treatment

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