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Transient left ventricular function deterioration after patent ductus arteriosus closure: A case series.
Mohammad Reza Sabri1, Chehreh Mahdavi1, Hamid Bigdelian2
1Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
SAGE Open Medical Case Reports
|May 16, 2025
Summary
Left ventricular ejection fraction can deteriorate years after patent ductus arteriosus closure. Large shunts are linked to worse outcomes and reduced cardiac function post-surgery.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Cardiac Surgery
Background:
- Patent ductus arteriosus (PDA) is a congenital heart defect.
- PDA closure is a common procedure, but post-surgical cardiac function changes are observed.
Observation:
- Nine patients with PDA experienced left ventricular ejection fraction deterioration after closure, ranging from immediate post-op to 3 years later.
- Ejection fraction dropped from 60-75% to 33-59%, and shortening fraction from 30-42% to 16-31%.
- All patients had moderate to large PDA, with one diagnosed with dilated cardiomyopathy.
Findings:
- Left ventricular ejection fraction deterioration can occur late after PDA closure, not just early.
- Large PDA size correlates with increased complications and reduced cardiac function post-closure.
- Both percutaneous and operative closure methods were associated with these cardiac function changes.
Implications:
- Clinicians should monitor cardiac function long-term after PDA closure, especially in patients with large shunts.
- Understanding delayed ventricular dysfunction is crucial for managing patients with a history of PDA.
- Further research is needed to elucidate the mechanisms behind late-onset ventricular decompensation post-PDA closure.
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