THE TRANSIENT EFFECTS OF TRANS-CATHETER PATENT DUCTUS ARTERIOSUS CLOSURE ON LEFT VENTRICULAR SYSTOLIC FUNCTION
Objectives: This study aims to measure changes in left ventricular systolic function after closure of patent ductus arteriosus and to find out echocardiographic predictors for LV dysfunction.
Methods: A prospective study was conducted from July 01, 2021, till June 30, 2022. The study included all patients who experienced percutaneous closure of PDA in this duration. LV function was assessed before and then one day, one month and three months after the transcatheter closure. Patients with preexisting LV dysfunction and significant associated cardiac lesions were excluded from study.
Results: PDA was occluded in 86 children by transcatheter intervention. Average age of the cohort was 65 ± 58 months with 70% female patients. The mean size of the ductus was 3.67 ± 1.78. LV systolic function remained normal in 65 patients (86%) while 21 patients (24%) suffered from a fall in systolic function of left ventricle after PDA occlusion. LVEDd, FS, and EF significantly dropped within 24 hours after occlusion of the ductus. LV- systolic dysfunction improved in almost all the patients at 3 months follow up except for 4 (4.6%) patients who had persistently poor systolic function of LV.
Conclusion: Trans-catheter closure of PDA can cause a significant but temporary decline in LV systolic function. Large PDAd, LAd, higher PDAd/AOd, LAd/AOd and larger LV dimensions can predict LV dysfunction in high-risk patients. More prospective studies are imperative to verify these observations and to determine the predicting parameters for dysfunction of left ventricle after closure of PDA.