caa a22 4500 388116110 CHVBK 20180307125407.0 cr unu---uuuuu 161130e199907 xx s 000 0 eng 10.1017/S1047951100005199 doi S1047951100005199 pii (NATIONALLICENCE)cambridge-10.1017/S1047951100005199 Difficulties generated by the small, persistently patent, arterial duct [Elektronische Daten] Over recent years, echo-Doppler cardiography has shown that a small, sometimes silent, arterial duct exists in more patients than previously recognized. To know the incidence of an arterial duct subsequent to therapy, we studied retrospectively our patients undergoing open-heart surgery and surgical or catheter closure. Three groups of patients were studied: those with patency of the duct subsequent to open heart surgery without any sign of patency before or during surgery, those with persistent duct after surgical ligation and those with persistent patency after attempted catheter occlusion with the Rashkind device. In the first group (of 431 children) four (0.9%) had persistence of this duct, of which three were silent. In the second group, patency persisted in four of 100 patients (4%), three being silent. In the last group there were five persisting shunts, three producing no murmur, in 30 patients (17%). We compared our results with those reported in the literature and conclude that echo-Doppler cardiography is needed to detect persistent shunting across a duct after therapy, since most of the residual ducts in this study were silent. This means that clinical findings alone cannot be relied upon, and careful echo-Doppler cardiography is essential. Also, the process of closure of a persistent duct by surgical ligation or transcatheter intervention is no guarantee of success. The risk of infective endocarditis is important in such persistent ducts and, at present, it is unknown either for a small, silent duct or in a persistent duct that remains open after attempted transcatheter closure, but now is in association with a foreign body. Copyright © Cambridge University Press 1999 Silent arterial duct nationallicence persistent arterial duct nationallicence duct after therapy nationallicence echo-Doppler cardiography nationallicence endocarditis nationallicence Raaijmaakers Brigitte Children's Heart Centre, University Hospital Nijmegen, The Netherlands Nijveld Aagje Children's Heart Centre, University Hospital Nijmegen, The Netherlands van Oort Anton Children's Heart Centre, University Hospital Nijmegen, The Netherlands Tanke Ronald Children's Heart Centre, University Hospital Nijmegen, The Netherlands Daniëls Otto Children's Heart Centre, University Hospital Nijmegen, The Netherlands Cardiology in the Young Cambridge University Press 9/4(1999-07), 392-395 1047-9511 9:4<392 1999 9 CTY https://doi.org/10.1017/S1047951100005199 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1017/S1047951100005199 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Raaijmaakers Brigitte Children's Heart Centre, University Hospital Nijmegen, The Netherlands NATIONALLICENCE 700 1- Nijveld Aagje Children's Heart Centre, University Hospital Nijmegen, The Netherlands NATIONALLICENCE 700 1- van Oort Anton Children's Heart Centre, University Hospital Nijmegen, The Netherlands NATIONALLICENCE 700 1- Tanke Ronald Children's Heart Centre, University Hospital Nijmegen, The Netherlands NATIONALLICENCE 700 1- Daniëls Otto Children's Heart Centre, University Hospital Nijmegen, The Netherlands NATIONALLICENCE 773 0- Cardiology in the Young Cambridge University Press 9/4(1999-07), 392-395 1047-9511 9:4<392 1999 9 CTY CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge