Efficacy and safety of occlusion therapy for patent ductus arteriosus infants in plateau and sub-plateau of Gansu Province, China / 第二军医大学学报

ABSTRACT

Objective: To evaluate the safety and efficacy of occlusion therapy for patent ductus arteriosus (PDA) infants in Gansu plateau and sub-plateau of China. Methods: A total of 300 PDA infants treated in Gansu Provincial People's Hospital between Jan. 2008 and Jan. 2018, including 123 patients from plateau area and 177 patients from sub-plateau area, were enrolled in this study. Their ages ranged from 6 months to 3 years. Anterior right heart catheter was blocked for measuring pulmonary artery pressure before occlusion during surgery. Different occlusion devices were selected according to the characteristics of PDA during the operation. Occlusion treatment for PDA patients with mild pulmonary hypertension was processed and testing occlusion was given to patients with moderate to severe pulmonary hypertension. After 1, 3, and 6 months follow-up, electrocardiogram, echocardiography and other data were examined, and changes in pulmonary artery pressure were evaluated based on the rate of tricuspid regurgitation. Results: A total of 300 patients receiving angiography showed defects, with the defect diameter being 1-10 (4.5 ± 2.8) mm before operation. After occlusion, 293 infants had no residual shunt. Totally 299 patients were successfully operated, and 97 patients with moderate to severe pulmonary hypertension were tested for hyperoxia and 21 infants with oxygen saturation <95% were given testing occlusion operation. And 235 patients were successfully blocked with PDA occlude, 53 micro-arterial catheters were occluded with German PFM Duct-Occlud, and 11 treated with ventricular septal defect occlude. One case aged 3 years old gave up treatment due to elevation of pulmonary artery pressure immediately after occlusion. Pulmonary systolic pressure and mean pulmonary artery pressure decreased in 299 patients 6 months after operation. Conclusion: Occlusion therapy is a reliable method for PDA infants in plateau and sub-plateau areas of Gansu Province, China, with definite curative effect and high success rate. Testing occlusion is a reliable method for identifying severe pulmonary hypertension, and choosing an appropriate occlusion device according to the individual conditions can achieve promising clinical outcomes.