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Published on: February 26, 2013
Long term follow-up of patients with patent ductus arteriosus after transcatheter closure
Yue Peng1,2, Zhenli Cheng1,2, Yan Zhang3
1Department of Cardiovascular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.
Insights
Long-term follow-up may be limited for pediatric patients after transcatheter closure for patent ductus arteriosus (PDA). Most patients experience no adverse events or recover fully, showing no abnormalities at 5-year follow-up.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect in pediatric patients.
- Transcatheter closure is a primary treatment for PDA, but adverse events can occur.
- Understanding the long-term implications of these events is crucial for patient management.
Purpose of the Study:
- To investigate concurrent, long-term, and future adverse events following transcatheter PDA closure in children.
- To assess the trend of adverse events and identify risk factors.
- To evaluate the necessity and value of prolonged follow-up monitoring.
Main Methods:
- A retrospective analysis of 1590 pediatric patients who underwent transcatheter PDA closure.
- Logistic regression to identify independent risk factors for concurrent adverse events.
- Chi-square test to analyze 5-year follow-up trends and outcomes.
Main Results:
- Low age, female sex, and high pulmonary artery diameter were identified as independent risk factors for concurrent adverse events.
- Patients without concurrent adverse events showed no abnormalities at 5-year follow-up.
- Most patients with initial adverse events also returned to normal by 5 years, with no significant differences between training and validation groups.
Conclusions:
- The value of extensive long-term follow-up may be limited for pediatric patients who have no concurrent adverse events or recover fully after transcatheter PDA closure.
- While follow-up is generally recommended, its cost and risks (e.g., sedation) should be weighed against limited benefits for certain patient groups.
- Risk stratification may help optimize follow-up strategies for pediatric PDA patients post-procedure.
Background:
To investigate the concurrent, long-term, and future adverse events and assess the trend of adverse events in pediatric patients with patent ductus arteriosus (PDA) after transcatheter closure.
Methods:
A total of 1590 patients underwent transcatheter PDA closure were enrolled, including 465 patients (median age = 22 months) in the training group and 1125 patients in the validation group. Logistic regression analysis was used to assess independent risk factors associated with concurrent adverse events after closure. The chi-square test was used to evaluate the 5-year follow-up trend.
Results:
Multivariable logistic regression analysis indicated that low age, female, and high pulmonary end diameter were independent risk factors for concurrent adverse events after closure. For patients without concurrent adverse events and for those who with concurrent adverse events but return to normal, the Chi-square test showed no abnormal results at the 5-year follow-up. Furthermore, the follow-up data of the validation group were not significantly different from those of the training group.
Conclusion:
The value of long-term follow-up of children may be limited for those who did not have a concurrent adverse event after closure nor for those who had a concurrent adverse event after closure but returned to normal during the 5-year follow-up period.
Impact:
Follow-up monitoring of adverse events tended to be recommended in pediatric patients with PDA after transcatheter closure. However, follow-up in these pediatric patients is expensive and there is a risk of sedation for echocardiography examination frequently. ·Patients who had no concurrent adverse events after closure did not show any abnormality at 5-year follow-up. ·Most of the patients who had concurrent adverse events after closure returned to normal at 5-year follow-up. The value of long-term follow-up may be limited for the above patients after transcatheter PDA closure.
