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Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results

Abstract

To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2.  More>>
Authors:
Bhalgat, Parag S; [1]  Pinto, Robin; Dalvi, Bharat V, E-mail: bharatdalvi@hotmail.com [2] 
  1. Department of Cardiology, King Edward VII Memorial Hospital, Mumbai, Maharashtra (India)
  2. Glenmark Cardiac Center, 10 Nandadeep, 209 Dr. Ambedkar Road, Matunga (East), Mumbai, Maharashtra (India)
Publication Date:
Jan 01, 2012
Product Type:
Journal Article
Resource Relation:
Journal Name: Annals of pediatric cardiology; Journal Volume: 5; Journal Issue: 2; Other Information: PMCID: PMC3487200; PMID: 23129901; PUBLISHER-ID: APC-5-135; OAI: oai:pubmedcentral.nih.gov:3487200; Copyright: (c) Annals of Pediatric Cardiology; This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BALLOONS; BYPASSES; CARDIOVASCULAR DISEASES; CLOSURES; CONGENITAL DISEASES; DEFECTS; DUCTS; EQUIPMENT; HYPERTENSION; PATIENTS; RESOLUTION; SAFETY; WEIGHT
OSTI ID:
22343746
Country of Origin:
India
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0974-2069; TRN: IN15$0263050080
Availability:
Available from http://dx.doi.org/10.4103/0974-2069.99614; Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487200
Submitting Site:
INIS
Size:
page(s) 135-140
Announcement Date:
Jun 19, 2015

Citation Formats

Bhalgat, Parag S, Pinto, Robin, and Dalvi, Bharat V, E-mail: bharatdalvi@hotmail.com. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results. India: N. p., 2012. Web. doi:10.4103/0974-2069.99614.
Bhalgat, Parag S, Pinto, Robin, & Dalvi, Bharat V, E-mail: bharatdalvi@hotmail.com. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results. India. doi:10.4103/0974-2069.99614.
Bhalgat, Parag S, Pinto, Robin, and Dalvi, Bharat V, E-mail: bharatdalvi@hotmail.com. 2012. "Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results." India. doi:10.4103/0974-2069.99614. https://www.osti.gov/servlets/purl/10.4103/0974-2069.99614.
@misc{etde_22343746,
title = {Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results}
author = {Bhalgat, Parag S, Pinto, Robin, and Dalvi, Bharat V, E-mail: bharatdalvi@hotmail.com}
abstractNote = {To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term.}
doi = {10.4103/0974-2069.99614}
journal = {Annals of pediatric cardiology}
issue = {2}
volume = {5}
journal type = {AC}
place = {India}
year = {2012}
month = {Jan}
}