PATENT DUCTUS ARTERIOSUS COMPLICATED BY PULMONARY HYPERTENSION AND REVERSED SHUNT

Patent ductus arteriosus is one ofthe most common types of congenitalheart disease.In the past 20 years ithas been proved by clinical experiencethat surgical intervention by ligation ordivision is not only an effective butalso a safe procedure.The mortalityrate for this operation in some of thelarger series reported in the literatureis 1-3%.But since the general use ofcardiac catheterization as a diagnosticprocedure for certain cardiac diseases,cases of patent ductus arteriosus havebeen found to be complicated by pul-monary hypertension.The clinical pic-ture of these cases may be quite dif-ferent from that of the usual type ofpatent ductus arteriosus;and,as regardstreatment,the presence of hypertensionrenders the usual procedure of ligationor division hazardous as death may