scholarly journals CATHETER BASED CLOSURE OF HYPERTENSIVE PDA(S) WITH UNCONVENTIONAL DEVICES –IMMEDIATE AND SHORT TERM FOLLOW UP

2020 ◽  
pp. 1-3
Author(s):  
Mirza Mohd Kamran ◽  
Mahua Roy ◽  
Amitabha Chattopadhyay ◽  
Sushil Shukla
Keyword(s):  
Ventricular Dysfunction ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Device Closure ◽  
Short Term ◽  
Pulmonary Arterial ◽  
Muscular Vsd ◽  
Severe Pulmonary Arterial Hypertension

Patent ductus arteriosus (PDA) is a common form of CHD, accounts for approximately 8% of congenital heart disease with the incidence of one in 2500 to 5000 live births. More common in female. It may be asymptomatic and is sometimes not diagnosed early resulting into prolonged abnormal aorto-pulmonary shunt which may result in silently progressing hypertension and left ventricular dysfunction. This study aims to evaluate the immediate &short-term follow up results after TCC of large PDAs with severe pulmonary arterial hypertension (PHT) in children.This is a observational study of 38 patients with Large PDA and severe PHT who were referred to this centre for treatment during the period from July 2015 to Feb 2018 . After evaluating clinical and hemodynamic parameters reversibility of severe PAH was established and transcatheter closure of PDA was performed. Patients were followed up clinically and echocardiographically at 24 hours, 1 month, 3 months, 6 months, 12 months and 24 months to assess the efficacy, safety of the procedure & its impact on PHT. Thirty eight patients, (26 females, 12males) patients between 6 months to 16 years of age had underwent successful device closure. 18 patients had PDA sizes between 6-8 mm,12 had between 8- 10 mm , 6 had between 10-15mm and only 2 patients had largest PDA more than 15 mm at PA end . 5 patients were selected for closure with muscular VSD device . We have successfully closed 3 of our largest PDA (12 mm , 16mm and 18mm) with Post Infarct Muscular VSD Occluder measuring 20 mm,22 mm and 24 mm respectively. TCC of hypertensive but reversible PDA is feasible. The immediate and short-term outcomes have proven this method to be safe and valid.

scholarly journals Post-interventional Evaluation and Follow-Up in Children With Patent Ductus Arteriosus Complicated With Moderate to Severe Pulmonary Arterial Hypertension: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xing Rong ◽  
Qiaofang Ye ◽  
Qiaoyu Wang ◽  
Jiajun Wang ◽  
Qiongjun Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Arterial Hypertension ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Interventional Therapy ◽  
Defect Correction ◽  
Pulmonary Arterial ◽  
Severe Pulmonary Arterial Hypertension ◽  
Patent Ductus

Background: Transcatheter closure is an important treatment for patent ductus arteriosus (PDA) complicated with moderate and severe pulmonary arterial hypertension (PAH). This report presents our experience with transcatheter closure of PDA complicated with moderate and severe PAH.Methods: The 49 cases of PDA complicated with moderate and severe PAH were collected in the Second Affiliated Hospital and Yuying Children's Hospital from January 2014 to December 2019 with transcatheter closure of PDA and follow-up. All patients were invited for transthoracic echocardiography, electrocardiogram, and thoracic radiography check-up.Results: Device implantation was successful in 48 of 49 patients (98.0%). Among them, 30 cases were in the PAH after defect correction (CD) group, and 19 examples were in the Non-PAH after defect correction (NCD) group. Pulmonary systolic pressure, left atrial diameter, and left ventricular end-diastolic diameter immediately after interventional therapy and 6 months later were lower than the pre-operative levels (p < 0.05). The incidence of the immediate residual shunt (RS) in this study was 34.9%, most of which were minimal amount shunt. RS disappeared in all patients within 1 year of therapy. Four patients had thrombocytopenia and one patient had left pulmonary artery stenosis. No other serious adverse event occurred during the follow-up period. The pressure gradient tricuspid valve regurgitation (PGTI) and the right heart catheterization (RHC) consistency points were 93.75% (15/16) and were within the 95% consistency limit by the Bland-Altman method. The Logistic regression analysis concluded that the pre-operative Pp/Ps and the narrowest diameter of PDA are risk factors for post-operative PAH (p < 0.05). The cut-off point of the pre-operative Pp/Ps and the narrowest diameter of PDA were calculated to be 0.595 and 4.75 mm, respectively.Conclusion: Interventional occlusion in children with PDA complicated with moderate and severe PAH is safe, effective, and has few complications. Targeted drug therapy has a good clinical effect. The narrowest diameter of PDA and the pre-operative Pp/Ps may be one of the risk factors of residual PAH after interventional therapy.

Transcatheter Treatment of Large Aortopulmonary Window: A Case Report

2015 ◽  
Vol 18 (6) ◽  
pp. 237 ◽  
Author(s):  
Zuoyuan Chen ◽  
Jidong Zhang ◽  
Xiaxia Wang ◽  
Quansheng Xing ◽  
Hui Xin ◽  
...  
Keyword(s):  
Case Report ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Heart Diseases ◽  
Aortopulmonary Window ◽  
Residual Shunt ◽  
Pulmonary Arterial ◽  
Muscular Vsd ◽  
Severe Pulmonary Arterial Hypertension

<strong>Introduction:</strong> Aortopulmonary window (APW), a large aortopulmonary septal defect (APSD), is a serious and rare defect within congenital heart diseases. <br /><strong>Case report:</strong> In this study, we reported an APW case with severe pulmonary arterial hypertension. This patient was successfully treated by transcatheter closure with a muscular ventricular septal defect (VSD) occluder. <br /><strong>Conclusion:</strong> We had a successful experience with transcatheter closure of a large APW using a muscular VSD occluder. There was no residual shunt or complications during the 6-month follow-up.

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