Long-term outcomes of percutaneous closure of patent ductus arteriosus
accompanied with unilateral absence of pulmonary artery
Abstract
Objective: This study aimed to evaluate the long-term outcome of
patients with PDA associated with UAPA. Methods: Patients diagnosed with
PDA associated with UAPA were retrospectively enrolled from January 2005
to June 2019. Clinical data, treatment and follow-up information were
evaluated. Results: 11 patients (5 males and 6 females) were diagnosed
with PDA associated with UAPA. Percutaneous closure was conducted in 9
patients successfully. The median age was 37 months. The mean diameter
of the PDA and occluders were 5.3±1.8mm (range 2-8.1 mm), 11.5±3.9 mm
(4-16 mm) respectively. The median in 5 patients with the pulmonary:
systemic flow ratio (Qp:Qs) was 1.41(1.28-8.7) and total lung resistance
was 12 wood (1.8-13.6) . The mean systolic pulmonary artery pressure was
68.3±19.1mmHg(42-105mmHg). In 5 patients with pre- and post-procedure
catheter data, the systolic pulmonary arterial pressure decreased
significantly after closure 77.0±20.2 v 58.8±17.5 mmHg (p = 0.024), and
so was the mean pulmonary arterial pressure 58.2±14.6 v 39.0±14.1 mmHg
(p = 0.18). The pulmonary artery pressure and heart size gradually
decreased to normal in 8 patients, and the quality of life was
significantly improved. The ratio of lung to systemic circulation
pressure in all these patients was less than 0.75. Conclusions: In
appropriate patients with PDA associated with UAPA, transcatheter
closure of PDA has the potential to improve the pulmonary artery
hypertension. The ratio of lung to systemic circulation pressure less
than 0.75 may be important reference index for predicting whether the
pulmonary artery pressure could be reduced to normal after occlusion.