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Prediction of left ventricular dysfunction after device closure of patent ductus arteriosus: proposal for a new functional classification.
Kiran, Viralam S; Tiwari, Ashish.
Afiliação
  • Kiran VS; Department of Paediatric Cardiology, Narayana Institute of Cardiovascular Sciences, Narayana Health City, Bangalore, India.
EuroIntervention ; 13(18): e2124-e2129, 2018 04 06.
Article em En | MEDLINE | ID: mdl-28741574
ABSTRACT

AIMS:

The aims of this study were to determine the incidence and correlates of left ventricular (LV) dysfunction amongst percutaneous patent ductus arteriosus (PDA) device closure patients, and to propose an indexed parameter for predicting LV dysfunction. METHODS AND

RESULTS:

In a retrospective cross-sectional analysis of 30 months duration, 447 patients who underwent PDA device closure were studied. The diameter of the PDA at the pulmonary artery end was measured in the angiograms in all patients and was indexed for their body surface area. The indexed PDA size was categorised into group A (1-2.9 mm/m², 35/447), B (3-5.9 mm/m², 254/447), C (6-8.9 mm/m², 66/447) and D (>9 mm/m², 35/447). Systolic LV function was evaluated using echocardiography at frequent intervals. Overall, 62.63% of the patients were female (280/447). At baseline, all 447 patients had normal LV function. LV dysfunction was seen in 102/447 (22.8%) patients with 2.8% in category A (1/35), 10.6% in category B (27/254), 34.1% in category C (42/123) and 91.4% in category D (32/35) after PDA device closure. Correlation of indexed PDA size and LV dysfunction was statistically significant (p<0.05).

CONCLUSIONS:

Accurate prediction of LV dysfunction is important in risk stratification, ICU management and counselling in PDA device closures. Indexed PDA size correlates well with post-procedural LV dysfunction. The authors propose a new classification of PDA utilising this accurate, reproducible and easy to perform parameter, which does not involve any extra cost, for risk stratification and early management in device closure of PDA.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cateterismo Cardíaco / Função Ventricular Esquerda / Disfunção Ventricular Esquerda / Permeabilidade do Canal Arterial / Dispositivo para Oclusão Septal Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: EuroIntervention Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / TERAPEUTICA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Índia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cateterismo Cardíaco / Função Ventricular Esquerda / Disfunção Ventricular Esquerda / Permeabilidade do Canal Arterial / Dispositivo para Oclusão Septal Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: EuroIntervention Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / TERAPEUTICA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Índia