Journal of Clinical Pediatrics ›› 2020, Vol. 38 ›› Issue (4): 275-.doi: 10.3969/j.issn.1000-3606.2020.04.008

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Intervention therapy of patent ductus arteriosus in children: a single-center observation and medium-long term follow-up

ZHOU Jiwei, YI Qijian, WANG Xianmin   

  1. Department of Cardiology, Children’s Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
  • Online:2020-04-15 Published:2020-04-15

Abstract: Objective To explore the complications and causes of interventional therapy for patent ductus arteriosus (PDA) in children. Methods The clinical data of children with PDA who underwent interventional occlusion from January 1, 2004 to January 1, 2019 were collected and the changes before and after occlusion and at the 1-year follow-up were compared. Results A total of 1408 children (482 boys and 926 girls) were included and a median age was 27.0 (2.0~215.0) months, and 1404 (99.72%) children were successfully closured by intervention. PDA was 3.3 (0.1~18) mm measured by echocardiography, and was 2.2 (0.1~18) mm measured by angiocardiography. The size of implanted device was (8.47±2.52) mm. Twenty-four hours after operation, there were 125 cases of residual shunt, 21 cases of thrombocytopenia, 31 cases of arrhythmia, 2 cases of hemolysis, 3 cases of arterial thrombosis, 4 cases of pseudoaneurysm, 1 case of right common iliac artery rupture, 1 case of right renal contusion, 4 cases of device shift, 1 case of aorta coarctation, 1 case of pulmonary artery stenosis and 1 case of anterior tricuspid valve chordae tendineae rupture. Multivariate logistic regression analysis showed that the female, the increasing severity of pulmonary hypertension and the increasing diameter of the occlusive device were independent risk factors for residual shunt after surgery (P<0.05). Conclusions The interventional therapy for PDA in children is safe and effective. Patients with PDA having large diameter and moderate to severe pulmonary hypertension had a higher incidence of postoperative complications.

Key words: patent ductus arteriosus,  interventional treatment,  complication,  child