Clinical outcomes of premature closure of the ductus arteriosus（PCDA）range from mild symptom to lethal respiratory insufficiency and pulmonary hypertension. This report describes a newborn with severe tricuspid insufficiency with rupture of the papillary muscle and persistent pulmonary hypertension due to PCDA. A routine fetal examination at 28 weeks of gestation did not show any abnormalities. Soon after birth the baby developed severe respiratory distress and cyanosis. He was resuscitated immediate after birth, and transferred to our hospital at 5 hours of age. Intensive care, including mechanical ventilation, inhaled nitric oxide, and infusion of vasoactive agonist were required. He recovered, but tricuspid regurgitation persisted, presumably because of irreversible ischemic damage of one papillary muscle. This case highlights the importance of differentiating PCDA in newborns with prolonged hypoxia and early transfer to a tertiary care center.
"},{"@language":"ja","@value":"動脈管早期閉鎖（premature closure of ductus arteriosus：PCDA）は胎児期に動脈管が閉鎖し，右心不全や新生児遷延性肺高血圧をきたす病態で，予後良好とする報告が多い一方で，稀に乳頭筋断裂による三尖弁閉鎖不全を合併し重篤な経過を辿ることもある．症例は在胎38週6日，体重2,924g，経腟分娩で出生した男児．妊娠28週までの胎児心エコーで異常を認めなかったが，生後全身チアノーゼが遷延し当院へ緊急搬送された．心エコーでPCDAと診断し，乳頭筋断裂，重度三尖弁逆流も認めた．鎮静下での人工呼吸管理，一酸化窒素吸入療法，循環作動薬投与等で急性期を脱したが，三尖弁逆流は退院時にも残存した．PCDAに乳頭筋断裂による三尖弁閉鎖不全を合併した重症例では速やかに三次医療機関で集中治療を開始し，急性期を脱した後も長期間のフォローアップが必要である．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410577519390140675","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Izumi Kengo"},{"@language":"ja","@value":"泉 健吾"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital"},{"@language":"ja","@value":"旭川医科大学病院周産母子センター新生児科"},{"@language":"en","@value":"Department of Pediatrics, Nayoro City General Hospital"},{"@language":"ja","@value":"名寄市立総合病院小児科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410577519390140678","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Sugiyama Tatsutoshi"},{"@language":"ja","@value":"杉山 達俊"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学病院周産母子センター新生児科"},{"@language":"en","@value":"Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410577519390140676","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Miyoshi Takamasa"},{"@language":"ja","@value":"三好 雄大"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"市立稚内病院小児科"},{"@language":"en","@value":"Department of Pediatrics, Wakkanai City Genaral Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410577519390140672","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Aoyama Aiko"},{"@language":"ja","@value":"青山 藍子"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学病院周産母子センター新生児科"},{"@language":"en","@value":"Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410577519390140674","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Nagaya Ken"},{"@language":"ja","@value":"長屋 建"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学病院周産母子センター新生児科"},{"@language":"en","@value":"Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410577519390140673","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Okamoto Toshio"},{"@language":"ja","@value":"岡本 年男"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital"},{"@language":"ja","@value":"旭川医科大学病院周産母子センター新生児科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410577519390140677","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Nii Mitsumaro"},{"@language":"ja","@value":"二井 光麿"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"旭川医科大学病院周産母子センター新生児科"},{"@language":"en","@value":"Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"1348964X"},{"@type":"EISSN","@value":"24354996"}],"prism:publicationName":[{"@language":"en","@value":"Journal of Japan Society of Perinatal and Neonatal Medicine"},{"@language":"ja","@value":"日本周産期・新生児医学会雑誌"},{"@language":"en","@value":"jjspnm"}],"dc:publisher":[{"@language":"en","@value":"Japan Society of Perinatal and Neonatal Medicine"},{"@language":"ja","@value":"一般社団法人 日本周産期・新生児医学会"}],"prism:publicationDate":"2023","prism:volume":"59","prism:number":"1","prism:startingPage":"77","prism:endingPage":"81"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2023257221"}],"availableAt":"2023","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=ductus%20arteriosus","dc:title":"ductus arteriosus"},{"@id":"https://cir.nii.ac.jp/all?q=premature%20closure","dc:title":"premature closure"},{"@id":"https://cir.nii.ac.jp/all?q=tricuspid%20insufficiency","dc:title":"tricuspid insufficiency"},{"@id":"https://cir.nii.ac.jp/all?q=ductus%20arteriosus","dc:title":"ductus arteriosus"},{"@id":"https://cir.nii.ac.jp/all?q=premature%20closure","dc:title":"premature closure"},{"@id":"https://cir.nii.ac.jp/all?q=tricuspid%20insufficiency","dc:title":"tricuspid insufficiency"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2010601735"}]}