Introduction: Patent ductus arteriosus is a common congenital heart defect. PDA accounts for 10% - 22% of CHD in various studies conducted in Nigeria. The addition of the paediatric cardiology sub-specialty unit at Federal Medical Centre Abeokuta was in 2013, and the centre began surgical PDA ligation in 2019. The general aim is to describe the prevalence, demographics and 10-year trend of PDA cases and our experience as a recent provider of surgical PDA ligation. The study set out to describe the prevalence, demographics and 10-year trend of PDA as seen at Federal Medical Centre, Abeokuta from January 2013 to December 2022 and also to describe the demographics and outcomes of patients who had PDA surgical closure from December 2019 to Dec 2022. Materials and Methods: This is an analytical cross-sectional study. Data was prospectively collected from all consecutive cases of Patent ductus arteriosus diagnosed by echocardiography in children aged 3 months to 15, between January 2013 and December 2022. Echocardiogram report was the main study instrument. All echocardiography was performed by the pediatric cardiologist using GE Vivid IQ and GE Vivid E95 with a probe frequency of 2.4 - 8.0 mHz. This machine has standard 2D echocardiography, Doppler and M-mode functions. Data was analysed using SPSS version 29 and Microsoft Excel. Results: A total of 90,894 patients were seen in all Paediatric units out of which 1065 new patients were evaluated using echocardiography during the period studied. Of these, 76 (8.2%) patients had PDA as a primary cardiac abnormality. Analysis of the trend shows that 5% of the reported PDA cases were seen in the first 2 years (2013-2014), following which the centre has recorded an increase in the number of cases. Hence 51% of the PDA cases were seen in the last 4 years. The mean age at diagnosis was 1.35 years ± 2.60. Females were more commonly affected than males with a male-to-female ratio of 1:1.15. In the study period, 19 (25%) had surgical ligation of PDA. Of these, 12 (63%), were done locally in our centre while 7 (31%) were done elsewhere. The youngest child at the time of surgery in our centre was 5 months old while the oldest was 9 years old. The average weight at surgery was 9.4 kg ± 7.0 and the smallest child by weight weighed 3.2 kg. There was no recorded perioperative mortality. Conclusion: PDA constitutes a significant burden of CHD in this study. Long-term medical treatment of hemodynamically significant PDA with anti-congestive medications can be avoided if more centres have the capacity for PDA closure. Providing holistic care from diagnosis to surgical or device PDA closure should be the goal of more secondary and tertiary centres in Nigeria as a route to scale up comprehensive paediatric cardiac services.
Cite this paper
Uzodimma, C. C. , Yusuf, M. K. , Sanni, S. B. , Olugbemi, A. J. , Onweluzo, E. O. and Egunjobi, M. O. (2023). Patent Ductus Arteriosus from Diagnosis to Surgical Closure: 10 Years Experience at Federal Medical Centre Abeokuta, Ogun State, Nigeria. Open Access Library Journal, 10, e872. doi: http://dx.doi.org/10.4236/oalib.1110872.
Gentile, R., Stevenson, G., Dooley, T., Franklin, D., Kawabori, I. and Pearlman, A. (1981) Pulsed Doppler Echocardiographic Determination of Time of Ductal Closure in Normal Newborn Infants. The Journal of Pediatrics, 98, 443-448.
https://doi.org/10.1016/S0022-3476(81)80719-6
Backes, C.H., Hill, K.D., Shelton, E.L., Slaughter, J.L., Lewis, T.R., Weisz, D.E., et al. (2022) Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider. Journal of the American Heart Association, 11, e025784.
https://doi.org/10.1161/JAHA.122.025784
Elsheikh, R.G., Darweish, A.Z., Elsetiha, M., Kamel, H. (2014) Comparative Study between Real Time Three Dimensional Echocardiogram and Angiography in Evaluation of Patent Ductus Arteriosus, Single Center Experience. Journal of Saudi Heart Association, 26, 204-211. https://doi.org/10.1016/j.jsha.2014.02.005
Arodiwe, I.O., Chinawa, J.M., Obidike, K.E., Omeje, I., Nzewi, O.C., Onukwuli, V. O., et al. (2019) Pediatric Echocardiography in University of Nigeria Teaching Hospital, Ituku-Ozalla: “Real-World Cardiology–Experience from a Center in Nigeria”. Journal of Medical Sciences, 39, 182-188.
https://doi.org/10.4103/jmedsci.jmedsci_1_19
Sadoh, W.E., Uzodimma, C.C. and Daniels, Q. (2013) Congenital Heart Disease in Nigerian Children: A Multicenter Echocardiographic Study. World Journal for Pediatric and Congenital Heart Surgery, 4, 172-176.
https://doi.org/10.1177/2150135112474026
Kolo, P.M., Adeoye, P.O., Omotoso, A.B. and Afolabi, J.K. (2012) Pattern of Congenital Heart Disease in Ilorin, Nigeria. Nigerian Postgraduate Medical Journal, 19, 230-234. https://doi.org/10.4103/1117-1936.169551
Jaiyesimi, F. and Antia, A.U. (1981) Congenital Heart Disease in Nigeria: A Ten-Year Experience at UCH, Ibadan. Annals of Tropical Paediatrics, 12, 77-85.
https://doi.org/10.1080/02724936.1981.11748065
Lai, W.W., Geva, T., Shirali, G.S., Frommelt, P.C., Humes, R.A., Brook, M.M., et al. (2006). Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography. Journal of the American Society of Echocardiography, 19, 1413-1430.
https://doi.org/10.1016/j.echo.2006.09.001
Abdulkadir, M. and Abdulkadir, Z. (2016) A Systematic Review of Trends and Patterns of Congenital Heart Disease in Children in Nigeria from 1964-2015. African Health Sciences, 16, 367-377. https://doi.org/10.4314/ahs.v16i2.5
Otaigbe, B.E. and Tabansi, P.N. (2014) Congenital Heart Disease in the Niger Delta region of Nigeria: A Four-Year Prospective Echocardiographic Analysis: Cardiovascular Topic. Cardiovascular Journal of Africa, 25, 265-268.
https://doi.org/10.5830/CVJA-2014-055
Okoromah, C.A., Ekure, E.N., Ojo, O.O., Animasahun, B.A. and Bastos, M.I. (2008) Structural Heart Disease in Children in Lagos: Profile, Problems and Prospects. The Nigerian Postgraduate Medical Journal, 15, 82-88.
https://doi.org/10.4103/1117-1936.181017
Song, H., Jiang, L.U. and Zhou, R. (2021) Associations of Altitude and Ethnic Groups with Congenital Heart Disease Prevalence in Primary and Secondary School Students in Five Provinces of China: A Screening Data Analysis. Chinese Journal of Public Health, 37, 1514-1516.