Immediate and Short-Term Changes in Left Ventricular Function in Children Undergoing Percutaneous Closure of Patent Ductus Arteriosus by Echocardiography and Tissue Doppler

Abstract

atent ductus arteriosus accounts for 5–10% of all congenital heart diseases. It occurs more commonly in premature infants. It is more common in females with a female to male ratio of 3: 1. Various genetic environmental factors, maternal infections and premature birth increases the incidence of the PDA. Left-to-right shunting through the PDA results in pulmonary overcirculation and left heart volume overload. The hemodynamic impact of PDA in cardiovascular system is determined by the magnitude of this shunting. PDA presents with a broad spectrum of clinical manifestations ranging from asymptomatic cardiac murmur to severe complications, including congestive heart failure or Eisenmenger's syndrome. Echocardiography is the gold standard to confirm the diagnosis and to characterize a PDA. Angiography defines the anatomy of the ductus arteriosus. Detailed assessment of the ductal anatomy is essential before transcatheter closure so that the proper device and device size can be chosen for the intervention. Cardiac catheterization is important in assessment of hemodynamics before transcatheter closure. Patency after 3months of age is considered abnormal, and treatment is warranted in symptomatic infants with a moderate to large PDA. Closure of PDA is definitely indicated