Aortic valve regurgitation following percutaneous closure of patent ductus arteriosus.

ABSTRACT

OBJECTIVES: To determine the incidence and outcome of aortic valve regurgitation (AR) following the percutaneous closure of patent ductus arteriosus (PDA). BACKGROUND: Aortic valve regurgitation is an overlooked consequence of percutaneous PDA closure. METHODS: Between December 2000 and May 2009, 51 children underwent percutaneous closure of PDA using Amplatzer Duct Occluders. Their median age at the time of the procedure was 2.6 years (range 0.6-18.0 years), and median weight was 14.0 kg (range 7.6-75.0 kg). Follow-up echocardiograms were performed a day after the procedure and at 1, 3, 12 months, and yearly thereafter. RESULTS: A day after the procedure, AR was detected for the first time in 13 of 48 patients (27.0%). A group of patients with newly developed AR was significantly different from a group of patients with competent aortic valves with respect to their age, weight, and minimal PDA diameter indexed to the body weight. The follow-up period ranged from 0.2 to 8.5 years (median 3.3 years) and at the latest follow-up evaluation, AR persisted in a single patient (2.0%) 6 years after the procedure. CONCLUSIONS: The aortic valve regurgitation following percutaneous PDA closure is trivial to mild and transient. It develops in approximately a quarter of children after percutaneous closure of PDA with a minimal diameter≥1.5 mm and is more likely to develop in infants and small children having significant left-to-right shunts.