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

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).

Clinical Value of Echocardiographic Screening and Dynamic Observations for Ductus Arteriosus Closure in Newborns

“…A children's ultrasound probe with a frequency of 3-8 MHz was used. The procedure of the examination is as follows: (1) The subjects lied down on their left side in a prone position. An ultrasound probe was used to scan the long axis of the parasternal left ventricle.…”

“…The incidence ratio between men and women is about 1:2. The disease can occur alone or be combined with other types of cardiovascular malformations, such as patent foramen ovale, atrial septal defect, atrial septal defect, pulmonary valve stenosis, aortic coarctation, and aortic valve stenosis [1,2] . The chances of children surviving complex congenital heart disease, such as hypoplastic left heart syndrome, aortic arch disconnection, pulmonary atresia with intact ventricular septum, and complete transposition of the great arteries are closely related to PDA.…”