Patent ductus arteriosus at low and high altitudes: anatomical and haemodynamic features and their implications for transcatheter closure.

BACKGROUND: Living at high altitude increases the prevalence of patent ductus arteriosus (PDA) and may affect its morphology. AIM: To compare the anatomical and haemodynamic features of isolated PDA in patients living at low and high altitudes (1,500-4,200 metres above sea level - m.a.s.l.). METHODS: We studied retrospectively data from 1,404 consecutive patients - 708 living in lowland areas (group L) and 696 in highland areas (group H), in whom transcatheter closure of PDA was attempted. The mean age of the patients in group L was 9.9 ± 13.5 years and in group H it was 8.2 ± 19.7 years. RESULTS: The diameter of PDA in group L was 2.3 ± 1.3 mm and 4.1 ± 1.2 mm in group H (p < 0.001), while the mean pulmonary artery pressure was 17.9 ± 5.9 mm Hg and 25.5 ± 12.3 mm Hg, respectively (p < 0.001). Angiographic PDA type A was more frequently observed in highland patients. In groups L and H, self expanding nitinol occluders (mostly Amplatzer devices) were used in 25.7% vs 92.2% of patients (p < 0.001), whereas coils were used in 69.2% vs 7.5% (p < 0.001), respectively. Double umbrella systems were used in 4.8% of patients in group L. CONCLUSIONS: In catheterised patients with PDA living at high altitude, larger ductal diameter, anatomic type A and higher pulmonary artery pressure were more frequently observed. This finding has important implications for future strategy regarding transcatheter closure in populations living at different altitudes. Kardiol Pol 2011; 69, 5: 431-436.

Cateterismo intervencionista en pacientes con circulación tipo Fontan / Interventional cardiac catheterization in patients with Fontan circulation

Hay numerosas aplicaciones de las técnicas de cateterismo intervencionista en el manejo de pacientes con circulación tipo Fontán. Estos procedimientos son seguros y exitosos. Llevan a la mejoría de las alteraciones hemodinámicas y a preservar la circulación en estos pacientes. Creemos que una estrategia que permita optimizar esta circulación imperfecta va a llevar a mejorar los resultados a largo plazo del bypass del ventrículo derecho

Cateterismo intervencionista en pacientes con circulación tipo Fontan / Interventional cardiac catheterization in patients with Fontan circulation

Hay numerosas aplicaciones de las técnicas de cateterismo intervencionista en el manejo de pacientes con circulación tipo Fontán. Estos procedimientos son seguros y exitosos. Llevan a la mejoría de las alteraciones hemodinámicas y a preservar la circulación en estos pacientes. Creemos que una estrategia que permita optimizar esta circulación imperfecta va a llevar a mejorar los resultados a largo plazo del bypass del ventrículo derecho (AU)