Magnitude of Residual Shunt and Associated Factors Among Children for Whom Surgical ligation Done for Patent Ductus Arteriosus at Tikur Anbessa Specialized Hospital and Cardiac Center Addis Ababa Ethiopia
| dc.contributor.advisor | Abebe Bezabih | |
| dc.contributor.author | Abdela Hayato | |
| dc.date.accessioned | 2025-03-20T14:07:21Z | |
| dc.date.available | 2025-03-20T14:07:21Z | |
| dc.date.issued | 2024-09-15 | |
| dc.description.abstract | Background: Patent ductus arteriosus is a congenital heart disease where the fetal ductus arteriosus does not close spontaneously after birth. Unless treated, its persistence results in nonphysiologic blood flow between the proximal descending thoracic aorta and the pulmonary artery. Among the operated patients with double ligation, 2 to 23% of them may develop residual shunts which may complicate with rare but fatal endarteritis and embolic phenomena. However, little is known about the magnitude of residual shunt and associated factors among children operated for patent ductus arteriosus in Ethiopia. Objective: To assess the magnitude of residual shunt and associated factors among children operated for patent ductus arteriosus at Tikur Anbessa Specialized Hospital and Cardiac Center, Addis Ababa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted by a retrospective chart review of 167 eligible children operated on from January 1, 2021 to December 31, 2023. The collected data was coded, cleaned, and exported into SPSS version 25 for analysis. Categorical variables were summarized using frequency tables and figures. Descriptive variables were summarized by using measures of central tendency and dispersions. Binary logistic regression analysis was conducted to check the associations between independent and outcome variables. Multivariate logistic regression analysis was employed to identify factors statistically associated with residual shunt. The strength of association was determined by using an adjusted Odds Ratio with its 95% confidence interval. Statistical significance was declared at a P-value <0.05. Result: The median (+ interquartile range) age of the participants was 4.2(+ 5.0) years. Among the study participants, 112(67 %) were females. The magnitude of residual shunt among children operated for patent ductus arteriosus was 22.2% (95% CI= 16.2 -28.1). In multivariate logistic regression analysis, only the presence of pulmonary hypertension showed a statistically significant association with residual shunt among children operated for PDA with surgical ligation. Accordingly, children who had pulmonary hypertension were 2.80 times (AOR=2.80, 95% CI: 1.265, 6.222) more likely to develop residual shunt after ligation for PDA compared to children who had no pulmonary hypertension before surgical intervention. Conclusion and Recommendation: The immediate post-operative prevalence of residual shunt in those patients for whom PDA ligation was done was significantly high in our setup. Another surgical approach, which is division and closure, should better be considered instead to avoid the risk of residual shunt and its long-term complications, particularly for children with pulmonary hypertension. Keywords: Patent ductus arteriosus, Surgical treatment, Residual shunt, children, Ethiopia | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/5184 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa University | |
| dc.subject | Patent ductus arteriosus Surgical treatment Residual shunt children Ethiopia | |
| dc.title | Magnitude of Residual Shunt and Associated Factors Among Children for Whom Surgical ligation Done for Patent Ductus Arteriosus at Tikur Anbessa Specialized Hospital and Cardiac Center Addis Ababa Ethiopia | |
| dc.type | Thesis |