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Patent Ductus Arteriosus with Persistent Pulmonary Artery Hypertension after Transcatheter Closure

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Objectives: To observe the change of pulmonary artery systolic pressure (PASP) of patients with persistent pulmonary arterial hypertension (PAH) after patent ductus arteriosus (PDA) occlusion.

Background: After occlusion of PDA with PAH, PAH can be persistent in some patients. Methods: A chest x ray, an electrocardiogram and an echocardiogram were performed on all patients at 24 hours, one month, six months and 1 year intervals serially.

Results: There was a significant fall (p<0.05) in mean PASP after occlusion (to 59.3(12.7)mmHg). However, the aortic pressure and SaO2 changed slightly (p﹥0.05). During the follow up, there was a further fall of PASP in 5 patients (NO 1, 5, 6, 7 and 8). Four patients (NO 2, 3, 4 and 8) showed the evidence of worsening of the PAH and were treated with sildenafil. Patient 2 died from acute right heart failure after a period of 11 months from the time of TCC (Transcatheter closure), triggered by pulmonary infection.

Conclusions: Some patients with borderline hemodynamic data with PDA and PAH can deteriorate or keep sustained PAH after PDA closure. The treatment of permanent closure to these patients must be cautious.

24 Aug, 2016
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e-Published: 30 Aug, 2016


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