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Patent Ductus Arteriosus in a Population-Based Study

Paediatric Department St. Luke's Hospital Guardamangia, Malta

For reprint information contact: Victor Grech, PhD, MRCP Tel: 356 24 1251 Ext. 1471 Fax: 356 24 0176 email: victor.e.grech{at}magnet.mt Paediatric Department, St. Luke's Hospital, Guardamangia, Malta.

This study was carried out to establish diagnostic and interventional trends in patent ductus arteriosus in a population-based study of births between 1935 and 1994 and to calculate the birth prevalence of this condition. This was done in the setting of a regional hospital catering for diagnosis and follow-up of all cases of congenital heart disease in Malta, under the supervision of visiting consultant pediatric cardiologists from the United Kingdom. Patent ductus arteriosus was diagnosed in 51 cases. Both age at diagnosis and age at surgery declined significantly in the period under study (p < 0.0001). Prior to the mid-1980s, preoperative diagnosis was made clinically with or without catheter confirmation. Subsequently, preoperative diagnosis was made almost exclusively by echocardiography. No mortality was associated with any of the interventions. Birth prevalence for the period 1980 to 1994 was 0.2 per 1000 live births. Rates for this lesion in historical studies vary widely from 0.09 to 2.11 per 1000 live births and this variation was attributed to methodological differences between studies. It was concluded that patent ductus arteriosus in Malta has been diagnosed and treated safely at progressively younger ages and this was attributed to improving medical services over the period studied.