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Percutaneous closure of hypertensive ductus arteriosus.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Zabal, Carlos García-Montes, José Antonio Buendía-Hernández, Alfonso Calderón-Colmenero, Juan Patiño-Bahena, Emilia Ia Juanico-Enríquez, Antonio Attié, Fause |
| Copyright Year | 2010 |
| Abstract | BACKGROUND The Amplatzer duct occluder (ADO) has been used with success to close large patent ductus arteriosus (PDA), but some problems exist especially with hypertensive PDAs, such as incomplete closure, haemolysis, left pulmonary artery stenosis, obstruction of the descending aorta and progressive pulmonary vascular disease. METHODS AND RESULTS We analysed a group of 168 patients with isolated PDA and pulmonary artery systolic pressure (PSAP) > or =50 mm Hg. Mean age was 10.3 +/- 14.3 years (median 3.9), PDA diameter was 6.4 +/- 2.9 mm (median 5.9), PASP was 63.5 +/- 16.2 mm Hg (median 60), Qp/Qs was 2.7 +/- 1.2 (median 2.5), total pulmonary resistance index (PRI) was 3.69 +/- 2.15 (median 3.35) and vascular PRI was 2.73 +/- 1.72 (median 2.37). We used ADOs in 145 (86.3%) cases, Amplatzer muscular ventricular septal defect occluders (AMVSDO) in 18 (10.7%), Amplatzer septal occluders (ASO) in three (1.8%) and the Gianturco-Grifka device in two (1.2%) cases. Device diameter was 106.3% +/- 51% higher than PDA diameter. PASP decreased after occlusion to 42.5 +/- 13.3 mm Hg (p<0.00001). Immediately after closure, no or trivial shunt was present in 123 (74.5%) cases. Immediate complications were device embolisation in five (3%) cases and descending aortic obstruction in one case. The overall success rate was 98.2%. Follow-up in 145 (86.3%) cases for 37.1 +/- 24 months (median 34.1) showed further decrease of the PASP to 30.1 +/- 7.7 mm Hg (p<0.0001). CONCLUSIONS Percutaneous treatment of hypertensive PDA is safe and effective. ADO works well for most cases, but sometimes other devices (MVSDO or ASO) have to be used. When cases are selected adequately, pulmonary pressures decrease immediately and continue to fall with time. |
| Starting Page | 1 |
| Ending Page | 6 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://kardter.narod.ru/he_96_8_625.pdf |
| PubMed reference number | 20357390v1 |
| Alternate Webpage(s) | https://doi.org/10.1136/hrt.2009.185025 |
| DOI | 10.1136/hrt.2009.185025 |
| Journal | Heart |
| Volume Number | 96 |
| Issue Number | 8 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | 4-S-(propionic acid)sulfidocyclophosphamide Abdominal aorta structure Amplatzer Septal Occluder Androgenetic Alopecia Aortic Valve Stenosis Cardiology discipline Closure Collecting Duct Carcinoma of the Kidney Diameter (qualifier value) Dietary Mercury Embolization, Therapeutic Heart Septal Defects Hemolysis (disorder) Hypertensive disease Idiopathic Pulmonary Fibrosis Left pulmonary artery Muscle Muscular ventricular septal defect Obstruction Patent ductus arteriosus Patients Peer Review Pulmonary artery stenosis Pulmonary artery structure Septal Occluder Device Structure of ductus arteriosus Systolic Pressure Vascular Diseases Vascular Neoplasms Ventricular Septal Defects aortic occlusion occluders |
| Content Type | Text |
| Resource Type | Article |
