Short-term results of interventional therapy for infants (7-36 months old) with patent ductus arteriosus and moderate-to-severe pulmonary hypertension: a retrospective study

Shu Y, Guo Y, Wang X, Zhou D.

J Cardiothorac Surg. 2020 Apr 22;15(1):68. doi: 10.1186/s13019-020-01110-5.

PMID: 32321548 Free PMC Article

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Abstract

Background: Patent ductus arteriosus (PDA) is a common congenital heart disease. Interventional therapy is an important treatment for PDA. Nevertheless, few studies have investigated the safety and effectiveness of interventional therapy for infants (age, 0-36 months) with PDA and moderate-to-severe pulmonary hypertension. Therefore, this study aimed to analyze the short-term (6 months) results and interventional therapy experience for infants with PDA and moderate-to-severe pulmonary hypertension.

Methods: Clinical records, echocardiographic data, and angiocardiography data of 28 infants (age, 7-36 months) who underwent interventional therapy for PDA and moderate-to-severe pulmonary hypertension between December 2011 and January 2017 at our hospital were retrospectively analyzed. All infants were treated using an Amplatzer occluder with local and deep sedation anesthesia under radiographic guidance.

Results: Infants with PDA and moderate-to-severe pulmonary hypertension had poor growth. Trace residual shunts were found in two infants immediately after procedure; both had disappeared by 6 months after procedure. No significant interventional therapy-related complications occurred in the other cases. Pulmonary systolic pressure, left atrial dimension, and left ventricular end-diastolic dimension immediately after interventional therapy and 6 months later were lower than the preoperative levels (P < 0.05). The left atrial and left ventricular end-diastolic dimensions at 6 months after interventional therapy were smaller than those immediately after interventional therapy (P < 0.05). Pulmonary systolic pressure rates immediately after interventional therapy and 6 months later were not significantly different (P = 0.505). Moreover, there were no significant differences in the left ventricular ejection fraction before, immediately after, and at 6 months after interventional therapy (P = 0.628).

Conclusions: For infants (age, 7-36 months) with PDA and moderate-to-severe pulmonary hypertension, interventional therapy can achieve excellent immediate and short-term (6 months) results with careful preoperative evaluations, strict operative procedures, and careful follow-up.

 

Fig. 1 Aortography prior to occlusion. The red arrow indicates the patent ductus arteriosus with a diameter of 5.89 mm. AO, aorta; PA, pulmonary artery

Fig. 2 Aortography results after occlusion. The red arrow indicates the occluder. There was no residual shunt after occlusion. AO, aorta

 

Fig. 3 Transthoracic echocardiography results before occlusion. The white arrow indicates the patent ductus arteriosus. PA, pulmonary artery; AO, aorta

 

Fig. 4 Transthoracic echocardiography results after occlusion. The red arrow indicates the occluder. There was no residual shunt after occlusion. PA, pulmonary artery; AO, aorta

 

source:https://pubmed.ncbi.nlm.nih.gov/32321548/

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