Intervention Therapy Of Patent Ductus Arteriosus In Children: Observation And Medium-long Term Follow-up

Objective: To explore the cause of complication in children with patent ductus arteriosus(PDA)accepted catheter interventional treatment.Methods: Cases report with PDA underwent interventional occlusion in Children's Hospital of Chongqing Medical University during 2004.01.01 to 2019.01.01.were collected.And their data information include: demographics,blood routine before and after treatment,chest film,electrocardiogram,echocardiogram,and one-year follow-up etc.Results: 1408 cases(482 meals and 926 females)were enrolled,1404(99.72%)cases had been successful interventional closured,age of the patients were 27.0(2.0~215.0)months.PDA was 3.3(0.1~18)mm measured by echocardiography,and was 2.2(0.1~18)mm measured by angiocardiography,size of implanted device was 8.47±2.52 mm.There were 125 cases(8.88%)had residual shunt,21 cases(1.49%)with thrombocytopenia,31 cases(2.20%)had arrhythmia,2 cases(0.14%)with hemolysis,3 cases(0.21%)had arterial thrombosis,4 cases(0.28%)with pseudoaneurysm,1 case(0.07%)had right renal contusion,1 case(0.07%)had right common iliac artery rupture,4 cases(0.28%)with device shift,1 case(0.07%)had aorta coarctation,1 case(0.07%)had pulmonary artery stenosis,1 case(0.07%)had tricuspid valve chordae break,in the 1408 cases after occlusion regimen.Follow-up at 1,3,6 and 12 months after operation: 78 cases with residual shunt completed 12-month follow-up,2 cases still had trace residual shunt and other cases disappeared during the 12-month follow-up,2 cases lost follow-up,1 case of I °atrioventricular block(Atrioventricular block,AVB)was still a high value of P-R,and the other cases recovered normal within 12 months.One case had ruptured chordae tendineae of the anterior tricuspid valve.During the 12-month follow-up,the tricuspid regurgitation was alleviated and the cardiac function was normal.Multivariate logistic regression showed that the female,the increasing severity of pulmonary hypertension and the increasing diameter of the occlusive device were independent risk factors for residual shunt after surgery(P<0.05).And the increasing severity of pulmonary hypertension,the residual shunt were the independent risk factors of thrombocytopenia.Conclusions: Catheter interventional treatment is impactful and safe in children with PDA.Children with large size of PDA and severe pulmonary arterial hypertension have high probability of complication,who should be pay more attention during interventional occlusion regimen.