A Preliminary Study On Evaluation Of The Short And Middle-Term Efficacy Of Transcatheter Closure In Middle-Aged And Elderly Patients With Patent Ductus Arteriosus Using Transthoracic Echocardiography

Objective To retrospectively study the changes of left cardiac morphology, left ventricular systolic function and systolic pulmonary artery pressure after transcatheter closure in middle-aged and elderly patients with patent ductus arteriosus (PDA) in order to evaluate the short and middle-term effect of closure using transthoracic echocardiographic (TTE).Methods Left ventricular end-diastolic diameter (LVEDD), left ventricularend-systolic diameter (LVESD), left atrium end-systolic diameter (LAESD), left ventricular ejection fraction (LVEF), Left ventricular fraction shortening (LVFS) and systolic pulmonary artery pressure (SPAP) of 44 PDA patients (age^40) who received successful occlusion were measured before and after transcatheter closure within 48 hours,1 month,2 month,6 month and 12 month using transthoracic echocardiographic to analyze the changes of the left cardiac geometry, left ventricular systolic function and pulmonary artery systolic pressure in middle-aged and patients with PDA.Results 1. In middle-aged and elderly patients, LVEDD was significantly reduced compared with pre-operation within 48hours after closure (P<0.05),but LVESD was stationary compared with pre-operation (P>0.05); LVEDD was .. declined continuously 1 month after closure, and LVESD began to decline 1 month after closure; LVEDD and LVESD was stabilized 3 month after closure (all P>0.05), until 12month after closure LVEDD and LVESD still larger than the value measured in healthy adults from the same region(all P<0.05); LAESD was reduced after closure (all P<0.05), but LAESD in 3month,6month and 12month showed no statistically significant compare with 1 month after closure (all P>0.05).2. LVEF and LVFS were reduced compared with pre-operation within 48hours after closure (P<0.05). LVEF, LVFS returned to the levels of pre-operation in lmonth after closure (P>0.05). LVEF and LVFS were progressively increased to levels over pre-operation in 3 months after closure (all P<0.05), but showed no statistically significant compared with 6month and 12month after closure (all P>0.05).3.SPAP was reduced after closure compared with pre-operation (all P<0.05),and SPAP was stabilized within 48hours after closure for 6 months(all P>0.05), and in 12months SPAP was decreased compare to the SPAP within 48hours after closure(P<0.05).Conclusions 1.Transcatheter closure of PDA can cause effective recovery in middle-aged and elderly patients in left cardiac geometric, and these changes seem more obvious in the short term after closure, until 12month after closure, left ventricular morphology has not been able to return to normal levels.2. Left ventricular systolic function was decreased transiently in middle-aged and elderly patients, but gradually returned to preoperative levels.3. SPAP was reduced after PDA closure progressively in middle-aged and elderly patients. 4.TTE could be used to observe the changes of left cardiac morphology and left ventricular systolic function after transcatheter closure termly and repeatedly and play an important role in evaluating the result of PDA closure.