Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results
Objective: To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). Background: TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2012-01-01
|
| Series: | Annals of Pediatric Cardiology |
| Subjects: | |
| Online Access: | http://www.annalspc.com/article.asp?issn=0974-2069;year=2012;volume=5;issue=2;spage=135;epage=140;aulast=Bhalgat |
| _version_ | 1811262599161970688 |
|---|---|
| author | Parag S Bhalgat Robin Pinto Bharat V Dalvi |
| author_facet | Parag S Bhalgat Robin Pinto Bharat V Dalvi |
| author_sort | Parag S Bhalgat |
| collection | DOAJ |
| description | Objective: To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT).
Background: TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT.
Methods: This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT.
Results: Of 76 patients, nine were found to have PDA with Eisenmenger′s syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients).
Conclusions: TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term. |
| first_indexed | 2024-04-12T19:29:45Z |
| format | Article |
| id | doaj.art-7147ee2759184b7bb1d3f9e129e63091 |
| institution | Directory Open Access Journal |
| issn | 0974-2069 |
| language | English |
| last_indexed | 2024-04-12T19:29:45Z |
| publishDate | 2012-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Pediatric Cardiology |
| spelling | doaj.art-7147ee2759184b7bb1d3f9e129e630912022-12-22T03:19:23ZengWolters Kluwer Medknow PublicationsAnnals of Pediatric Cardiology0974-20692012-01-015213514010.4103/0974-2069.99614Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term resultsParag S BhalgatRobin PintoBharat V DalviObjective: To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). Background: TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. Methods: This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Results: Of 76 patients, nine were found to have PDA with Eisenmenger′s syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). Conclusions: TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term.http://www.annalspc.com/article.asp?issn=0974-2069;year=2012;volume=5;issue=2;spage=135;epage=140;aulast=BhalgatCongenital heart diseasedevice closurehemodynamicspediatric intervention |
| spellingShingle | Parag S Bhalgat Robin Pinto Bharat V Dalvi Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results Annals of Pediatric Cardiology Congenital heart disease device closure hemodynamics pediatric intervention |
| title | Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results |
| title_full | Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results |
| title_fullStr | Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results |
| title_full_unstemmed | Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results |
| title_short | Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results |
| title_sort | transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension short and intermediate term results |
| topic | Congenital heart disease device closure hemodynamics pediatric intervention |
| url | http://www.annalspc.com/article.asp?issn=0974-2069;year=2012;volume=5;issue=2;spage=135;epage=140;aulast=Bhalgat |
| work_keys_str_mv | AT paragsbhalgat transcatheterclosureoflargepatentductusarteriosuswithseverepulmonaryarterialhypertensionshortandintermediatetermresults AT robinpinto transcatheterclosureoflargepatentductusarteriosuswithseverepulmonaryarterialhypertensionshortandintermediatetermresults AT bharatvdalvi transcatheterclosureoflargepatentductusarteriosuswithseverepulmonaryarterialhypertensionshortandintermediatetermresults |