| Background: Patent ductus arteriosus (PDA) is one of the common congenital heart diseases,which cause volume overload of the left side of the heart and predisposes the patients to endocarditis. Porstmann was the first man who successfully performed the transcatheter closure of PDA. From then on,there were many instruments used in treatment of PDA. Masura report their experience of using Amplatzer duct occluder in 1998 for the first time. This technology has evolved over the last 10 years in the world. Most PDAs are closed in the catheterization laboratory now. Little is known,however,of the changes in left heart size and function after percutaneous PDA closure.Objective:To evaluate the change of left heart size and systolic function before and after closure of PDA using Amplatzer occluder device.Methods:Before PDA closure,on the following 2-3 days,and 3 months thereafter, left ventricular diastolic and systolic diameter,left atrial diameter,and left ventricular systolic function were examined by two-dimensional(2D) echocardiography. Control subjects comprised of 22 paroxysmal supraventricualr tachycardia patients without any confirmed heart disease, excluding the patients with hypertension, diabetes mellitus, and reformed heart. Echocardiography was routinely performed before radiofrequency catheter ablation. Amplatzer duct occluder was used in every patient.Statistical analysis:All statistical analysis were performed with SPSS 12.00 software. All indices were tested by One-way ANOVA. The figures of the patients between before closure and after colsure is compared using the paired-samples t test. The figures of the patients and controls is compared using the independent- samples t test.Results:Left atrial diameter was larger in the PDA group before closure than in the control group(p=0.001). It markedly decreased on the following 2-3 days after closure (p< 0.001). At 3 months after closure,no differences appeared between the two groups(p = 0.419). Left ventricular diastolic diameter and systolic diameter were larger in the PDA group before closure than in the control group(p< 0.001). They also markedly decreased on the following 2-3 days after closure(p< 0.001, p=0.007). But there were still differences between the two groups(p=0.020, p=0.024) at 3 months after closure. LVEF was slightly lower in the PDA group before closure than in the control group(p=0.188). It markedly decreased on the following 2-3 days after closure(p=0.005). It was lower than before closure (p=0.022),and also lower than the control group (p=0.012). No patient had symptomaticheart failure.Conclusions:(1) Transcatheter closure of patent ductus arteriosus using Amplatzer occluder device is safe, effective.(2) Compared with before closure, LA,LVDd and LVDs in the PDA group markedly reduced on the following 2-3 days and 3 months after closure. LVEF decreased, reflects ease of high hemodynamical state.(3) Compared with the control group,LA in the PDA group before closure was larger. The difference disappeared on the following 2-3 days and 3 months after closure.(4) Compared with the control group, LVDd and LVDs in the PDA group before closure were larger. The difference maintains on the following 2-3 days and 3 months after closure.(5) Compared with the control group,there was no difference of LVEF between the two groups. On the following 2-3 days and 3 months after closure, LVEF decreased markedly, reflects ease of high hemodynamical state after relieved volume overload. |
