Aortic valve regurgitation following percutaneous closure of patent ductus arteriosus

Abstract

The aortic valve regurgitation following percutaneous PDA closure is trivial to mild and transient. It develops in approximately a quarter of children after percutaneous closure of PDA with a minimal diameter≥1.5 mm and is more likely to develop in infants and small children having significant left-to-right shunts.

Case Report: Aortic Regurgitation of Postocclusion and Long-Term Outcome Following PDA Correction in an Adult Dog

“…However, further studies on a larger number of cases are required to evaluate this. In humans, AR is reported to be one of the possible complications following PDA occlusion (9,10,19,20). Although the exact incidence remains unknown, postocclusion AR is known to occur rarely in human patients with PDA (20).…”

“…However, severe AR that is hemodynamically relevant and AR lasting more than 6 years have also been reported in humans (9,20). Therefore, identifying postocclusion AR is considered clinically important in humans, and distinguishing it from other diseases with poor prognosis, such as infective endocarditis, rheumatic fever, or connective tissue disease, is also necessary (9,10,20). AR after Amplatz R Duct Occluder deployment was more likely to develop in human patients with hemodynamically significant left-to-right PDA shunts, and the MDD indexed to body weight was significantly larger in patients with newly developed AR compared with patients with no AR (9).…”

“…Therefore, identifying postocclusion AR is considered clinically important in humans, and distinguishing it from other diseases with poor prognosis, such as infective endocarditis, rheumatic fever, or connective tissue disease, is also necessary (9,10,20). AR after Amplatz R Duct Occluder deployment was more likely to develop in human patients with hemodynamically significant left-to-right PDA shunts, and the MDD indexed to body weight was significantly larger in patients with newly developed AR compared with patients with no AR (9). In another human study (10), larger PDA shunt size corrected for body weight and higher Qp/Qs were significant risk factors for development of AR following coil occlusion of PDA.…”

“…In humans, the occurrence of aortic regurgitation (AR) after percutaneous PDA occlusion using coil or Amplatz ® Duct Occluder has been reported in some patients ( 9 , 10 ). Identification of this postocclusion AR is important for managing patients and determining their prognosis, and it is necessary to distinguish it from ARs due to other causes such as infective endocarditis or connective tissue diseases ( 9 ).…”

Infective endocarditis of the aortic valve in a Border collie dog with patent ductus arteriosus

“…Factors that may adversely affect reverse remodeling include older age at PDA closure, myocardium failure following long-term volume overload and residual shunt [ 31 ]. In addition, it has been reported in humans that AR may occur after ductus arteriosus occlusion due to disappearance of the large shunt flow and geometric changes in the aortic root [ 3 ]. In dogs with PDA, the increased diastolic pressure in the aorta following ductus arteriosus closure may worsen AR [ 19 ].…”