Korean Circulation Journal  2008;38(11):596-600

doi:10.4070/kcj.2008.38.11.596

Transient Left Ventricular Dysfunction After Percutaneous Patent Ductus Arteriosus Closure in Children.

Yeo Hyang KIM 1 ; Hee Joung CHOI ; Yongkeun CHO ; Sang Bum LEE ; Myung Chul HYUN

Affiliations

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Keywords

Ductus arteriosus, patent; Catheter closure; Ventricular dysfunction

Country

Republic of Korea

Language

English

Abstract

BACKGROUND AND OBJECTIVES: The goal of this study was to assess changes in left ventricular (LV) function and to identify pre-closure factors associated with LV dysfunction {fractional shortening (FS) below 29%} after transcatheter patent ductus arteriosus (PDA) closure. SUBJECTS AND METHODS: Forty-three pediatric patients with PDAs underwent cardiac catheterization for hemodynamic studies and intervention. Doppler echocardiography was performed at pre-closure, post-closure, and follow-up. RESULTS: S' and A' of the septum and mitral annulus were significantly decreased at post-closure and follow-up, respectively. In five of eight patients with Qp/Qs ratios over 1.60 and Pp/Ps ratios over 0.32 at pre-closure, the FS was decreased below 29% at post-closure. Qp/Qs ratio over 1.60 and Pp/Ps ratio over 0.32 at pre-closure had a sensitivity of 86% and a specificity of 84% for predicting FS to be below 29% at post-closure. CONCLUSION: Larger amounts of pre-closure left-to-right shunting and higher pulmonary artery pressure were associated with an increased likelihood of FS <29% after closure. The results of this study suggest that serial assessments of ventricular function are needed after PDA occlusion in patients with high Qp/Qs and Pp/Ps ratios.