PDA Device Closure

Hemalatha R1,*, Ms.Ranjitha2,

1Nursing Supervisor, Kauvery Heartcity, Trichy, India

2 Senior Staff Nurse, Kauvery Heartcity, Trichy, India

*Correspondence: nursing.heartcity@kauveryhospital.com

Abstract

Patent Ductus Arteriosus (PDA) is a common form of congenital heart disease and forms about 5-10% of congenital heart disease. Device closure of a PDA is described here.

Background

Patent Ductus Arteriosus (PDA) is a common form of congenital heart defect with an incidence of one in 2500 to 5000 live births. The presence of volume over loading of the left atrium and left ventricle is indication for closure of the defect. The risk of endocarditis, aneurysm of PDA or pulmonary vascular disease are also indications for closure. Closure eliminates left to right shunting volume over load of the left side circulation and the risk for pulmonary hypertension and endocarditis.

Surgical closure of PDA is safe and effective. However certain patients may experience some morbidity including bleeding, inadvertent left pulmonary artery ligation, recurrent laryngeal nerve damage and residual shunting.

Case Preasentation

The baby was a 9-year-old female. She was diagnosed with PDA, no PAH, with normal ventricular function. In view of the above findings, the patient was advised PDA closure. Two months back patient attended the Congenital Heart Disease detection camp at school and was diagnosed with a heart problem. Family brought the patient for PDA device closure plan.

Examination

CVSS1 S2 SAO2 100% RA
RSBAE (+) BP 90/60
D/A-Soft HR100b/m
CNSNFND RR24bm
Temp Normal

Provisional Diagnosis

Acyanotic congenital heart disease.

ECG:

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Provisional-Diagnosis-2

ECHO Report:

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Before procedure Image

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After procedure Image

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Provisional-Diagnosis-7

Treatment

“0” POD

Inj.Propofol – 2ml – IV

Inj.Glycopyrolate – 1ml

Inj.Heparin – 1800U

Discharge Medication Advised

Syp.Emeset – 5ml – SOS

Diet Advice

Normal diet

Nursing Management

  1. Patient was received from Cath lab to IV – GW anesthetic continuous cardiac monitoring.
  2. Nurses maintained an every 15mins check BP chart, BP was stabilized with inotropes and IV fluids.
  3. Doctors explained the patient’s condition to the attenders nurses obtained consent for the clinical procedure after proper counseling.
  4. Nurses used AIDET techniques acknowledge, introducing, duration, explanation and thank you, while communicating with patient and attenders, to give their confidence and improve the satisfaction level.
  5. Patient stabilized discharged followed as per doctor’s advice.

Outcome

On discharge patient was hemodynamically stable.

Hemalatha

Ms. R. Hemalatha,

Nursing Supervisor, Kauvery Heartcity

Ranjitha

Ms. Ranjitha,

Senior Staff Nurse, Kauvery Heartcity

Kauvery Hospital