Characteristics of Patent Ductus Arteriosus in Congenital Rubella Syndrome

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Congenital Abnormalities

Background:

• Congenital rubella syndrome (CRS) is a significant cause of birth defects.
• Cardiac complications, particularly patent ductus arteriosus (PDA), are common in CRS.
• Understanding the specific characteristics of CRS-associated PDA is crucial for effective management.

Purpose of the Study:

• To investigate the clinical characteristics of cardiac complications in patients with CRS.
• To compare the features of PDA in children with CRS (CRS-PDA) versus those without CRS (non-CRS-PDA) undergoing transcatheter closure.
• To identify specific PDA morphologies in CRS patients that may influence treatment decisions.

Main Methods:

• Retrospective review of medical records for CRS patients admitted to Children's Hospital 1, Vietnam (Dec 2010-Dec 2012).
• Analysis of CRS patients who underwent PDA transcatheter occlusion therapy (Dec 2009-Dec 2015).
• Comparison of CRS-PDA (n=50) and non-CRS-PDA (n=290) patients undergoing transcatheter PDA closure (Jul 2014-Dec 2015).

Main Results:

• Cardiac defects (99%), cataracts (72%), and hearing impairment (7%) were prevalent in enrolled CRS patients (n=108).
• CRS-PDA patients had lower birth weight, more frequent pulmonary and aortic stenosis, and higher pulmonary/aortic pressures compared to non-CRS-PDA patients.
• Tubular-type PDA was significantly more common in CRS-PDA patients (16%) than in non-CRS-PDA patients (3%), often associated with hypertension and stenosis.

Conclusions:

• Congenital rubella syndrome is strongly associated with specific cardiac anomalies, notably PDA.
• Patients with CRS-PDA present with distinct clinical and hemodynamic profiles compared to non-CRS-PDA patients.
• The higher prevalence of tubular-type PDA in CRS necessitates careful device selection and procedural planning for transcatheter closure.