https://www.um.edu.mt/library/oar/handle/123456789/27511 2026-04-15T03:15:37Z https://www.um.edu.mt/library/oar/handle/123456789/4134 Title: Morphology of the patent arterial duct : features relevant to treatment Authors: Matsui, Hikoro; McCarthy, Karen; Ho, Siew Yen Abstract: Patent ductus arteriosus (PDA), one of the most common congenital heart defects, is an abnormal persistence of a patent lumen in the arterial duct due to an arrest of the natural process of closure after it has served its function as a vital channel in fetal circulation. The histological feature of the arterial duct is entirely different from its adjoining arteries and many intrinsic substances mediate in the process of its normal closure. When existing in isolation, catheter or surgical intervention is usually used for its treatment. Ductal aneurysm is a rare type of PDA. The PDA associated with other congenital heart disease has variable morphology and closing it naturally or by intervention may produce critical symptoms. The PDA and its ligament which represents a closed arterial duct can be part of a vascular ring with abnormal aortic arch formation. It is important to understand the morphological features of PDA so as to choose the optimal strategy for treatment. 2008-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/4133 Title: Coil occlusion of the large patent Ductus Arteriosus Authors: Kumar, Rajiv K.; Nair, Amrita C. Abstract: While coil occlusion is well accepted for the small patent ductus arteriosus (PDA), occlusive devices are preferred for the larger (> 3 mm) ducts by most institutions. Because of costs concerns, occlusive devices are not always realistic in many countries. The technique of simultaneous delivery of multiple coils with bioptome assistance works well for relatively larger ducts. This technique requires careful case selection through echocardiography. The duct anatomy plays a crucial part in determining the suitability for coil occlusion. Coil occlusion has a specific advantage for relatively larger ducts in selected small children and in preterm infants because it is possible to accomplish delivery of multiple coils through relatively small introducer sheaths. In addition, aortic narrowing is less likely because coils compact in the ampulla. This review describes case selection strategies and techniques of coil occlusion of the large PDA. Relevant illustrative images are shown. 2008-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/4103 Title: Central venous catheters in children and neonates (part 2) : access via the internal jugular vein Authors: Trieschmann, U.; Kruessell, Markus; Udink ten Cate, Floris; Sreeram, Narayanswami Abstract: Central venous access via the internal jugular vein (IJV) is safe, relatively easy and very commonly used in infants and children undergoing cardiac surgery for congenital heart disease. Because of the wide range of anatomical variations an ultrasound-guided technique is advantageous in many cases, in particular in patients who have had previous punctures or those in whom difficulties are anticipated for various reasons. The right internal jugular vein is the preferred vein for central venous access as it offers straight access to the superior vena cava. The rate of complications - insertion-related as well as long term - are lower compared to the femoral and the subclavian access. 2008-01-01T00:00:00Z