PMID- 23106886
OWN - NLM
STAT- MEDLINE
DCOM- 20131119
LR  - 20141120
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Linking)
VI  - 125
IP  - 21
DP  - 2012 Nov
TI  - Transcatheter closure of large patent ductus arteriosus with severe pulmonary 
      arterial hypertension in adults: immediate and two-year follow-up results.
PG  - 3844-50
AB  - BACKGROUND: Transcatheter closure of patent ductus arteriosus (PDA) is a well 
      established procedure and an accepted treatment modality for small to 
      moderate-sized PDA. This study aimed to evaluate the immediate and follow-up 
      results of transcatheter closure of large PDAs with severe pulmonary arterial 
      hypertension (PAH) in adults. METHODS: After a complete hemodynamic evaluation 
      differentiating from the reversibility of severe PAH, transcatheter closure of 
      PDA was performed. Patients were followed up clinically and echocardiographically 
      at 24 hours, 1 month, 3 months, 6 months, 12 months and 24 months after 
      occlusion. RESULTS: Twenty-nine patients had successful occlusion, pulmonary 
      artery pressure (PAP), left ventricular ejection fraction (LVEF) and fractional 
      shortening (FS) significantly decreased immediately after occlusion ((106 +/- 25) 
      mmHg vs. (50 +/- 14) mmHg, P < 0.01; (63.7 +/- 7.2)% vs. (51.4 +/- 10.1)%, P < 0.01 and 
      (36.9 +/- 8.2)% vs. (28.9 +/- 8.6)%, P < 0.05, respectively). At 1 month after PDA 
      closure, the signs and symptoms improved markedly in all 29 patients, and PDAs 
      were completely closed and remained closed during the follow-up. Eighteen 
      patients having different degrees of dyspnea were treated with angiotensin 
      converting enzyme inhibitor (ACEI) and/or digoxin after occlusion. Nine patients 
      whose pulmonary vascular resistence (PVR) > 6 Wood units accepted targeted PAH 
      therapy. After 1 to 3 months of peroral drug therapy, their exercise tolerance 
      improved from New York Heart Association (NYHA) class III-IV to NYHA class I. 
      During follow-up, no latent arrhythmias were found, the left atrial diameter 
      (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular 
      end-systolic diameter (LVESD), left ventricular mass index (LVMI) and pulmonary 
      artery systolic pressure (PASP) decreased significantly (P < 0.05), and FS and 
      LVEF recovered compared to the immediate postclosure state. However, FS and LVEF 
      remained low compared to the preclosure state. CONCLUSIONS: Transcatheter closure 
      of large PDA with severe PAH is feasible, effective, and safe in adults. 
      Significant left ventricular systolic changes may occur after closure of large 
      PDA, and left ventricular function usually recovers within a few months.
FAU - Zhang, Cao-Jin
AU  - Zhang CJ
AD  - Department of Cardiology, Guangdong General Hospital & Guangdong Cardiovascular 
      Institute, Guangzhou, Guangdong 510100, China. yszcj74@163.com
FAU - Huang, Yi-Gao
AU  - Huang YG
FAU - Huang, Xin-Sheng
AU  - Huang XS
FAU - Huang, Tao
AU  - Huang T
FAU - Huang, Wen-Hui
AU  - Huang WH
FAU - Xia, Chun-Li
AU  - Xia CL
FAU - Mo, Yu-Jing
AU  - Mo YJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Ductus Arteriosus, Patent/physiopathology/*surgery
MH  - Familial Primary Pulmonary Hypertension
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension, Pulmonary/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Vascular Resistance
MH  - Ventricular Function, Left
MH  - Ventricular Remodeling
EDAT- 2012/10/31 06:00
MHDA- 2013/11/20 06:00
CRDT- 2012/10/31 06:00
PHST- 2012/10/31 06:00 [entrez]
PHST- 2012/10/31 06:00 [pubmed]
PHST- 2013/11/20 06:00 [medline]
PST - ppublish
SO  - Chin Med J (Engl). 2012 Nov;125(21):3844-50.