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KMID : 0368120080380110596
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Korean Circulation Journal
2008 Volume.38 No. 11 p.596 ~ p.600
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Transient Left Ventricular Dysfunction After Percutaneous Patent Ductus Arteriosus Closure in Children
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Kim Yeo-Hyang
Cho Yong-Keun
Hyun Myung-Chul
Lee Sang-Bum
Choi Hee-Joung
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Abstract
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Background and Objectives: The goal of this study was to assess changes in left ventricular (LV) function and to identify pre-closure factors associated with LV dysfunction {fractional shortening (FS) below 29%} after transcatheter patent ductus arteriosus (PDA) closure.
Subjects and Methods: Forty-three pediatric patients with PDAs underwent cardiac catheterization for hemodynamic studies and intervention. Doppler echocardiography was performed at pre-closure, post-closure, and follow-up.
Results: S’ and A’ of the septum and mitral annulus were significantly decreased at post-closure and follow-up, respectively. In five of eight patients with Qp/Qs ratios over 1.60 and Pp/Ps ratios over 0.32 at pre-closure, the FS was decreased below 29% at post-closure. Qp/Qs ratio over 1.60 and Pp/Ps ratio over 0.32 at pre-closure had a sensitivity of 86% and a specificity of 84% for predicting FS to be below 29% at post-closure.
Conclusion: Larger amounts of pre-closure left-to-right shunting and higher pulmonary artery pressure were associated with an increased likelihood of FS <29% after closure. The results of this study suggest that serial assessments of ventricular function are needed after PDA occlusion in patients with high Qp/Qs and Pp/Ps ratios.
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KEYWORD
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Ductus arteriosus, patent, Catheter closure, Ventricular dysfunction
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