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Percutaneous closure of patent ductus arteriosus in children: Immediate and short-term changes in left ventricular
Saurabh Kumar Gupta1, Km Krishnamoorthy, Jaganmohan A Tharakan
1Department of Cardiology, Sree Chitra Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Insights
Percutaneous closure of patent ductus arteriosus (PDA) can cause temporary left ventricular (LV) systolic dysfunction in children. Diastolic function recovery lags behind systolic function recovery, but both improve over time.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Cardiovascular Physiology
Background:
- Limited research exists on left ventricular (LV) hemodynamic changes, particularly diastolic function, following patent ductus arteriosus (PDA) closure.
- Understanding these effects is crucial for managing pediatric cardiac patients.
Purpose of the Study:
- To assess the impact of percutaneous patent ductus arteriosus (PDA) closure on left ventricular (LV) systolic and diastolic function in children.
- To identify predictors of post-procedural LV dysfunction.
Main Methods:
- Thirty-two children with isolated PDA underwent trans-catheter closure.
- Two-dimensional echocardiography and tissue Doppler imaging evaluated LV systolic and diastolic function pre-closure, day 1 post-closure, and at follow-up.
Main Results:
- Twenty-five percent of children developed transient LV systolic dysfunction one day after PDA closure.
- Baseline LV ejection fraction, LV end-systolic dimension, and PDA diastolic gradient predicted post-closure LVEF.
- Poorer baseline diastolic function was observed in patients who developed post-closure LV systolic dysfunction.
Conclusions:
- Percutaneous PDA closure is linked to reversible LV systolic dysfunction in children.
- Improvement in LV diastolic function trails behind systolic function recovery post-closure.
Objective:
To evaluate the effect of percutaneous closure of patent ductus arteriosus (PDA) on left ventricular (LV) systolic and diastolic function in children.
Background:
Limited studies are available on alteration in LV hemodynamics, especially diastolic function, after PDA closure.
Methods:
Thirty-two consecutive children with isolated PDA treated by trans-catheter closure were studied. The LV systolic and diastolic function were assessed by two-dimensional (2D) echocardiography and tissue Doppler imaging 1 day before the PDA closure, on day 1, and on follow-up.
Results:
At baseline, none of the patients had LV systolic dysfunction. On day 1 post-PDA closure, 8 (25%) children developed LV systolic dysfunction. The baseline LV ejection fraction (LVEF), LV end-systolic dimension (LVESD), and PDA diastolic gradient predicted the post-closure LVEF. Patients who developed post-closure LV systolic dysfunction had poorer LV diastolic function than those who did not. LV diastolic properties improved after PDA closure; however, the improvement in LV diastolic properties lagged behind the improvement in the LV systolic function. All children were asymptomatic and had normal LVEF on follow up of >3 months.
Conclusions:
Percutaneous closure of PDA is associated with the reversible LV systolic dysfunction. Improvement in the LV diastolic function lags behind that in the LV systolic function.
