PATENT DUCTUS ARTERIOSUS A FOLLOW-UP STUDY OF 73 CASES

Abstract

The best known studies of the eventual effects of patency of the ductus arteriosus are based upon autopsy results. They suggest a high incidence of serious complications such as bacterial endocarditis and congestive heart failure. Table Maude Abbott's (1937) survey of 92 cases included 20 who died under 5 years of age, and 16 who died of causes not directly attributable to the patent ductus. Commenting on these figures, Brown (1950) points out that " our ideas are mainly based on post-mortem cases and take little account of the living.... The adult case of patent ductus is a rare visitor to the clinic and the condition appears to be equally rare on post-mortem examination.... There must be spontaneous closure of the ductus more often than is generally realized, or cases are missed when failure supervenes and the characteristic physical signs disappear." TABLE I PATENT Ducrus ARTERIOSUS-NECROPSY FINDINGS Average age at Deaths from Deaths from Authors No. of cases death (in years) subacute bacterial heart failure endocarditis Maude Abbott, 1937.. .. 92 24 27 24 (29%o) (26%) Bullock et al., 1939 (excluding 80 29 42 18 children under 4 years) (53%) (23%) Keys and Shapiro, 1943 (ex- 60 36 25 17 cluding children under 17 (42%) (28%) years)