Assessment of Left Ventricular Dysfunction Post Transcatheter Patent Ductus Arteriosus Closure in Pediatric Patients
DOI:
https://doi.org/10.51253/pafmj.v75iSUPPL-3.12677Keywords:
Diameter of aorta, Fractional shortening, Left atrial diameter, Left ventricular dysfunctionAbstract
Objectives: To compare Left Ventricular (LV) function before and after Transcatheter Patent Ductus Arteriosus (PDA) closure and to identify factors associated with LV dysfunction following device closure.
Study Design: Quasi- experimental study.
Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, Jan to Jun 2024.
Methodology: A non-probability consecutive sampling technique was used for patient selection. Thirty patients aged upto 18 years who underwent PDA device closure were enrolled. Echocardiographic parameters were measured before, 24 hours after device closure and at 1 and 3 months. Assessment of pre procedure LV function was done upon admission of the patient and the parameters were recorded in predesigned profoma using M mode echocardiography, TDI and Speckled tracking. Trans catheter device closure of PDA was done using standard procedure and following the standard guidelines.
Results: Out of 30 patients, 17(56.7%) were males and 13(43.3%) were females. The median age of patients was 4.00(2.75-6.00) year. After 24 hours of procedure, 5(16.7 %) patients developed LV dysfunction. Patients with LV dysfunction had a median PDA diameter of 8.00(8.00-9.00) mm. LAd/AOd ratio 1.24(1.22-1.32) was significantly higher in patients with LV dysfunction (p<0.05). The LAd, LVEDD, LVESD and LVEDVI showed a significant decline following procedure and throughout the course of 3 months (p<0.001).
Conclusions: Transcatheter PDA closure causes a decrease in LV performance immediately post procedural closure, which recovers completely within 3 months. Pre closure LAd/Aod ratio and PDA diameter were found to be an important markers in anticipating LV dysfunction ...
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References
Shulman A, Gordon A, Judin J, Foster C, Kazi A, Masemola M, et al. Associations and prevalence of Patent Ductus Arteriosus amongst neonates in an academic hospital, 2013–2020: a retrospective study.
https://doi.org/10.1136/archdischild-2023-rcpch.236
Kindler A, Seipolt B, Heilmann A, Range U, Rüdiger M, Hofmann SR. Development of a Diagnostic Clinical Score for Hemodynamically Significant PatentDuctusArteriosus.FrontPediatr.2017;5:280.
https://doi.org/10.3389/fped.2017.00280
Georgiev S, Tanase D, Eicken A, Peters J, Hörer J, Ewert P. Transvenous, Echocardiographically Guided Closure of Persistent Ductus Arteriosus in 11 Premature Infants: A Pilot Study. JACC Cardiovasc Interv. 2021;14(7):814-816.
https://doi.org/10.1016/j.jcin.2021.01.009
Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, et al.; Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology (ESC); Association for European Paediatric Cardiology (AEPC); ESC Committee for Practice Guidelines (CPG). ESC Guidelines for the management of grown-up congenital heart disease Eur Heart J. 2010 (23):2915-2957.https://doi.org/10.1093/eurheartj/ehq249
Bruckheimer E, Steiner K, Barak-Corren Y, Slanovic L, Levinzon M, Lowenthal A, et al. The Amplatzer duct occluder (ADOII) and Piccolo devices for patent ductus arteriosus closure: a large single institution series. Front Cardiovasc Med. 2023;10:1158227. https://doi.org/10.3389/fcvm.2023.1158227
Jeong YH, Yun TJ, Song JM, Park JJ, Seo DM, Koh JK, Lee SW, Kim MJ, Kang DH, Song JK. Left ventricular remodeling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure. American heart journal. 2007 ;154(3):436-440.
https://doi.org/10.1016/j.ahj.2007.04.045
Galal MO, Amin M, Hussein A, Kouatli A, Al-Ata J, Jamjoom A. Left ventricular dysfunction after closure of large patent ductus arteriosus. Asian Cardiovasc Thorac Ann. 2005(1):24-29.
https://doi.org/10.1177/021849230501300106
Talat S, Sheikh AM, Sattar H, Kanwal A, Akbar T, Asghar H. the transient effects of trans-catheter patent ductus arteriosus closure on left ventricular systolic function. J Pak Med 2023;34(02):88-92
https://doi.org/10.51642/ppmj.v34i02.576
Eerola A, Jokinen E, Boldt T, Pihkala J. The influence of percutaneous closure of patent ductus arteriosus on left ventricular size and function: a prospective study using two- and three-dimensional echocardiography and measurements of serum natriuretic peptides. J Am Coll Cardiol. 2006;47(5):1060-1066.
https://doi.org/10.1016/j.jacc.2005.09.067
Galal MO, Arfi MA, Nicole S, Payot M, Hussain A, Qureshi S. Left ventricular systolic dysfunction after transcatheter closure of a large patent ductus arteriosus. J Coll Physicians Surg Pak. 2005 ;15(11):723-725.
Gupta SK, Krishnamoorthy K, Tharakan JA, Sivasankaran S, Sanjay G, Bijulal S, et al. Percutaneous closure of patent ductus arteriosus in children: Immediate and short-term changes in left ventricular systolic and diastolic function. Ann Pediatr Cardiol. 2011 ;4(2):139-144.
https://doi.org/10.4103/0974-2069.84652
Kim YH, Choi HJ, Cho Y, Lee SB, Hyun MC. Transient Left Ventricular Dysfunction After Percutaneous Patent Ductus Arteriosus Closure in Children. Korean Circ J. 2008;38(11):596-600. https://doi.org/10.4070/kcj.2008.38.11.596
Kluckow M, Lemmers P. Hemodynamic assessment of the patent ductus arteriosus: Beyond ultrasound. Semin Fetal Neonatal Med. 2018 (4):239-244..
https://doi.org/10.1016/j.siny.2018.04.002
Sharma AK, Agarwal A, Sinha SK, Razi MM, Pandey U, Shukla P, et al. An echocardiographic evaluation to determine the immediate and short-term changes in biventricular systolic and diastolic functions after PDA device closure-an observational analytical prospective study (echo- PDA study). Indian Heart J. 2021 ;73(5):617-662.https://doi.org/10.1016/j.ihj.2021.06.017
Zhan Z, Guan L, Pan W, Zhang X, Zhang L, Zhou D, Ge J. Left ventricular size and function after percutaneous closure of patent ductus arteriosus in Chinese adults. Int. J. Cardiol. 2020 ;315:24-28. https://doi.org/10.1016/j.ijcard.2020.04.060
Bischoff AR, Jasani B, Sathanandam SK, Backes C, Weisz DE, McNamara PJ. Percutaneous Closure of Patent Ductus Arteriosus in Infants 1.5 kg or Less: A Meta-Analysis. J Pediatr. 2021 ;230:84-92.e14..https://doi.org/10.1016/j.jpeds.2020.10.035
Apalodimas L, Waller Iii BR, Philip R, Crawford J, Cunningham J, Sathanandam S. A comprehensive program for preterm infants with patent ductus arteriosus. Congenit Heart Dis. 2019 ;14(1):90-94.https://doi.org/10.1111/chd.12705
Bhat YA, Almesned A, Alqwaee A, Al Akhfash A. Catheter Closure of Clinically Silent Patent Ductus Arteriosus Using the Amplatzer Duct Occluder II-Additional Size: A Single-Center Experience. Cureus. 2021;13(8):e17481.
https://doi.org/10.7759/cureus.17481
Chinawa JM, Chukwu BF, Chinawa AT, Duru CO. The effects of ductal size on the severity of pulmonary hypertension in children with patent ductus arteriosus (PDA): a multi-center study. BMC Pulm Med. 2021;21(1):79.
https://doi.org/10.1186/s12890-021-01449-y
Irfan M, Ali M, Tobing TC, Dalimunthe W, Adriansyah R. Time period after transcatheter PDA closure with changes in left ventricular function and nutritional status. Paediatr. Indones. 2021 ;61(2):100-106.
https://doi.org/10.14238/pi61.2.2021.100-6
Amoozgar H, Salehi S, Farhadi P, Edraki MR, Borzoee M, Ajami G, et al.Follow-Up Results of Device Occlusion of Patent Ductus Arteriosus. Iran J Pediatr. 2016 26(3):e3621.
https://doi.org/10.5812/ijp.3621
Hou M, Qian W, Wang B, Zhou W, Zhang J, Ding Y et al. Echocardiographic Prediction of Left Ventricular Dysfunction After Transcatheter Patent Ductus Arteriosus Closure in Children. Front Pediatr. 2019 ;7:409.
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