Comparison of transcatheter patent ductus arteriosus closure between children and adults

Heart Vessels. 2020 Nov;35(11):1605-1613. doi: 10.1007/s00380-020-01639-4. Epub 2020 Jun 3.

Abstract

The data comparing the characteristics and effect of transcatheter patent ductus arteriosus (PDA) closure between children and adults is scarce. We analyzed 54 consecutive patients who underwent transcatheter PDA closures. We divided the patients into 2 groups of < 18 years and ≥ 18 years and compared the hemodynamic changes before and after the PDA closure. Adults had a higher incidence of heart failure on admission, diagnoses by heart failure and incidental echocardiography, PDA calcifications, and procedural complications than children (all P < 0.05). The left ventricular end-diastolic volume index (LVEDVI), left atrial diameter index (LADI), and LV mass index (LVMI) decreased after the PDA closure in children but not in adults. The LV ejection fraction (LVEF) significantly decreased 1 day after the PDA closure in both groups but remained low at 6 months after the procedure in only adults. The percent change in the LVEDVI, LADI, LVMI, and LVEF from baseline to 6 months after the procedure was significantly lesser in adults than children (LVEDVI: - 5.2 ± 29.1% vs. - 34.9 ± 18.9%, LADI: - 7.0 ± 13.2% vs. - 22.1 ± 18.9%, LVMI: - 11.0 ± 16.5% vs. - 34.1 ± 15.7%, LVEF: - 5.9 ± 7.6% vs. 6.1 ± 9.1%, all P < 0.05). Transcatheter PDA closure was not associated with a reduction in the LV and LA volume as well as an improvement in the LV hypertrophy and LV function in adults as compared to children. We suggested that an early diagnosis and transcatheter PDA closure during childhood might provide clinical benefit before progressive LV remodeling and heart failure.

Keywords: Amplatzer duct occluder; Hemodynamic change; Patent ductus arteriosus; Transcatheter closure.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Cardiac Catheterization* / adverse effects
  • Cardiac Catheterization* / instrumentation
  • Child, Preschool
  • Ductus Arteriosus, Patent / complications
  • Ductus Arteriosus, Patent / diagnostic imaging
  • Ductus Arteriosus, Patent / physiopathology
  • Ductus Arteriosus, Patent / therapy*
  • Female
  • Heart Failure / etiology
  • Heart Failure / physiopathology
  • Hemodynamics
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Recovery of Function
  • Retrospective Studies
  • Risk Factors
  • Septal Occluder Device
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left
  • Ventricular Remodeling