Clinical characteristics and efficacy of interventional therapy in Tibetan children with patent ductus arteriosus

Gu Yan; Wang Xiaofang; Guo Baojing; Liang Yongmei; Xiao Yanyan; Wang Zhiyuan; Lyu Zhenyu; Jin Mei

doi:10.3760/j.issn.1673-4777.2018.06.007

Abstract：Objective To analyze the clinical characteristics and efficacy of interventional therapy in Tibetan children with patent ductus arteriosus(PDA).Methods Ninety-nine Tibetan children with PDA who had transcatheter closure in Beijing Anzhen Hospital,Capital Medical University from January 2015 and December 2016 were enrolled;the mean age was(127 ±48) months;the mean height was (130 ± 18)cm;the mean weight was (27 ± 11)kg;68 children(68.7％) had pulmonary artery hypertension.All patients were diagnosed by X-ray,echocardiography and angiography;PDA type and diameter of arterial duct were observed;the effect of PDA closure was observed by echocardiography and angiography 2 d after operation.Results Krichenko classification of aortic arch showed 56 cases of funnel type (56.6％),19 cases of weird type (19.2％),15 cases of long type (15.2％),6 cases of short type (6.1％) and 3 cases of stenotic type (3.0％).According to the minimum diameter of PDA,the children were divided into group A (＜ 2 mm),group B (2-4 mm),group C (＞4-＜6 mm),group D(6-＜ 10 mm) and group E(≥ 10 mm).Right heart catheterization showed the ratio of pulmonary flow to systemic blood flow ＞ 1.5 in all children.Nine children with severe pulmonary artery hypertension had successful permanent transcatheter closure.No postoperative complication was observed.Left ventricular end-diastolic dimension,pulmonary arterial pressure and left ventricular ejection fraction 2 d after operation were significantly lower than those before operation in group B,C,D,E (P ＜ 0.05).Conclusions Incidence of pulmonary artery hypertension is high in Tibetan children with PDA;long type,weird type and large diameter of PDA are common.Transcatheter closure has a good curative effect on PDA in Tibetan children.