The silent patent ductus arteriosus.
OBJECTIVE
To describe the characteristics and outcome of children with an isolated silent patent ductus arteriosus (SPDA), with comparison to non-silent ducts.


METHODS
Between 1999 and 2004, all consecutive cases of isolated silent and non-silent-patent ductus were recorded at the National Register of Pediatric and Congenital Heart Disease, Lebanese Society of Cardiology. Patients with a SPDA were followed clinically and by Doppler echocardiography while all non-SPDA were percutaneously or surgically closed.


RESULTS
Twenty-four cases of isolated SPDA and 50 cases of isolated non-SPDA ducts were recorded. Male sex was significantly predominant in the silent group (70%). First-cousin consanguinity rates were not different between both groups, with 20.4% for the silent group versus 22% for the non-silent group. Down's syndrome was associated in three cases of SPDA. No cases of endocarditis were noted during a mean follow-up of 33.3 months. Four patients with a SPDA experienced spontaneous closure at the age of 25, 30, 36 and 58 months.


CONCLUSIONS
SPDA is a relatively benign disease. The risk of endocarditis cannot be totally ignored, but the systematic closure of the SPDA is not warranted. Larger series and longer follow-up are needed in order to draw conclusions. Spontaneous closure occurred in four patients with SPDA.
Chehab
Ghassan
G
Department of Pediatrics, Hôtel-Dieu de France Hospital, Beirut, Lebanon. ChehabGh@cyberia.net.lb
Saliba
Zakhia
Z
El-Rassi
Issam
I
D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000601:surgery; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006326:Heart Auscultation; D006337:Heart Murmurs / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007861:Lebanon; D008297:Male; D012075:Remission, Spontaneous; D012189:Retrospective Studies