Patent ductus arteriosus associated with pulmonary hypertension and desaturation

Khositseth, Anant; Wanitkun, Suthep

doi:10.5603/cj.2012.0101

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…ADO is a withdrawable device, thus, temporary attempted occlusion of PDA with occluder has been used to decide on the contribution of left to right shunt and pulmonary vascular resistance to PAH, which is safe and efficient. [ 13 14 ] The systemic and pulmonary artery pressure (PAP) were compared before and after the balloon occlusion for 10–30 min, if the PAP decreased by 20% of the level before the attempted closure or decreased by more than 30 mmHg, without significant fluctuation in aortic pressure and blood oxygen saturation, without patient discomfort, this kind of PAH can be considered as dynamic PAH and the closure device can be released permanently. [ 15 ] In our study, 43 patients with severe PAH underwent transcatheter closure using ADO.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

Jin

Liang

Wang

et al. 2015

Chinese Medical Journal

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Background:Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices.Methods:One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications.Results:Median age and median weight were 4.0 years (range: 0.3–52.0 years old) and 15.3 kg (range: 4.5–91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%).Conclusions:Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

Jin

Liang

Wang

et al. 2015

Chinese Medical Journal

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“…One had desaturation only at room air oxygen (21% oxygen) but well saturated with 100% oxygen, subsequently underwent successful device closure of the PDA with improvement. 11 PDA can be closed by transcatheter device closure or by surgery. In comparison to surgery transcatheter closure is mostly preferred by parents because of avoiding bypass, short hospital stay and PDA closure without any scar mark.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Patent Ductus Arteriosus with Pulmonary Arterial Hypertension of Down Syndrome Children: Case Reports

Nazrin¹

2020

SJC

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Patent ductus arteriosus is common congenital heart disease in Down syndrome children. Patent ductus arteriosus (PDA) can cause repeated pneumonia, pulmonary hypertension, congestive cardiac failure, and an increased risk for endocarditis. Transcatheter closure of PDA is preferential therapeutic alternative to surgical ligation. Two Down syndrome babies associated with PDA with pulmonary arterial hypertension are described with the history of failure to thrive, developmental delay, and recurrent hospital admission for LRTI. We closed their PDA with Amplatzer PDA device successfully. One baby had additional mild right pulmonary artery (RPA) stenosis and atrial ectopic which disappeared within 6 months of the procedure. His frequency of LRTI gradually decreased and growth pattern also improved. Another baby had moderate sized PDA with moderate pulmonary hypertension with almost same type of history. Additionally, she had history of heart failure with pneumonia for two times. But she had good flow in branch pulmonary arteries and normal heartbeat. She improved clinically and hemodynamically after 6 months after the procedure. We could help both the parents in time to get rid of anxiety with their Down syndrome children for their cardiac and respiratory problems. Infact a Down syndrome baby needs a good social support for maintenance of their life at least near to normal.

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“…Occurrence of the pulmonary vascular disease is accelerated in patients with Down syndrome and advancing age. [ 1 2 ] Test occlusion of the PDA with balloon or occluder device is often utilized in the catheterization laboratory to decide operability of large hypertensive ducts. [ 3 4 ] In patients, who demonstrate clear left to right flows on echocardiography across the ducts and lack of oxygen desaturation in lower limbs, if the pulmonary artery pressure shows a significant fall and separation from aortic pressure, the ducts are considered operable.…”

Section: Introductionmentioning

confidence: 99%

A novel method of creation of a fenestration in nitinol occluder devices used in closure of hypertensive patent arterial ducts

Singhi

Sivakumar

2016

Ann Pediatr Card

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Test occlusion with a balloon is done to predict operability of large hypertensive patent ductus arteriosus (PDA). If the fall in the pulmonary artery pressures is inadequate, a complete closure is not desired. To create a predictable premeasured fenestration in a nitinol occluder device used for closing hypertensive PDA. A large nitinol occluder device was punctured with an 18G needle to advance a 0.035˝ stiff guide wire through the occluder before loading it into the delivery system. The occluder with the guidewire was then deployed across the PDA. A coronary guide catheter was later threaded through the guidewire into the fabric of the device, which was still held by the delivery cable. A coronary stent was deployed across the fenestration in the occluder to keep it patent. An 8-year-old boy with Down syndrome and hypertensive PDA was hemodynamically assessed. Even though there was a fall in the pulmonary vascular resistance index and pressures on test occlusion, the pulmonary artery pressures were labile with fluctuations. A customized fenestration was made in a 16 mm muscular ventricular septal defect occluder (MVSO) with a 4.5 mm bare-metal coronary stent. The pulmonary artery pressures remained at half of the aortic pressures after the procedure. This fenestration model precisely and predictably fenestrated a large occluder device used to close a hypertensive large PDA. Long-term patency of these fenestrations has to be assessed on the follow-up, and may be improved through larger fenestrations, systemic anticoagulation and use of covered stents.

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Patent ductus arteriosus associated with pulmonary hypertension and desaturation

Abstract: We present the cases of three children with patent ductus arteriosus (PDA) (Cardiol J 2012; 19, 5: 543-546)

Cited by 4 publications

References 7 publications

A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

Transcatheter Closure of Patent Ductus Arteriosus with Pulmonary Arterial Hypertension of Down Syndrome Children: Case Reports

A novel method of creation of a fenestration in nitinol occluder devices used in closure of hypertensive patent arterial ducts

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