ABSTRACT

IMMEDIATE AND EARLY RESULT OF TRANSCATHETER CLOSURE OF LARGE

PATENT DUCTUS ARTERIOSUS WITH PULMONARY HYPERTENSION
Radityo Prakoso, Poppy S. Roebiono, Indriwanto Sakidjan, Yovie
Kurniawati, Oktavia Lilyasari, Anna Ulfah Rahajoe, Ganesja Moelia
Harimurti
Division of Pediatric Cardiology and Congenital Heart Disease
Department of Cardiology and Vascular Medicine University of
Indonesia
National Cardiovascular Center Harapan Kita

Background
Transcatheter closure has become an established procedure for the patent
ductus arteriosus (PDA). However, it remains challenging in large PDA with
pulmonary hypertension due to technical difficulties and possible complications.
This study aims to evaluate the immediate and early results of such cases.
Methods
Retrospective study has been conducted from July 2013 until June 2014 in
National Cardiovascular Center Harapan Kita with total of 13 patient. Minimum
PDA diameter of 5 mm and pulmonary hypertension confirmed with
hemodynamic evaluation by catheterization were included in this study. The
immediate and early results were observed clinically, by catheterization and
echocardiography.
Results
Patient age ranged from 1 to 37 years (mean 14.7 years). Eleven patients
(84.6%) were female and 2 patients (15.4%) were male. All patients have room
air oxygen saturation above 90%, continuous murmur, and cardiomegaly.
Measured by catheterization, the PDA size ranged was 5.64 to 13 mm (mean 8.8
mm). Pulmonary hypertension was confirmed by measurement of mean
pulmonary artery pressure (mPAP). Mean of all mPAP patients is 48mmHg. All of
the patients successfully underwent transcatheter closure with immediate
residual PDA confirmed by catheterization occur in 5 patients (38.5%, minimal
residual) and no residual PDA in 8 patients (61.5%). No immediate complications
that occur until 24 hours after procedure were observed. The follow up data in
outpatient office were then evaluated. Majority of patients were clinically and
echocardiographically assessed after a week to a month.Two patients were loss
to follow up. No early complications were found in the rest of the patients.
Minimal residual PDA was observed in one patient. The average length of stay
was two days.
Conclusions
Transcatheter occlusion in large PDA with pulmonary hypertension was found to
be effective and safe.
Keywords
Large PDA, pulmonary hypertension, transcatheter occlusion