Aortic valve regurgitation following transcatheter closure of patent ductus arteriosus in adults: A clinical analysis / 第二军医大学学报

ABSTRACT

Objective To determine the incidence, risks and outcome of aortic regurgitation (AR) following transcatheter closure in adult patients with patent ductus arteriosus (PDA). Methods A total of 101 patients with PDA treated by transcatheter closure were enrolled in this study. Of them, 26 patients (25.74%) had new or increased AR following closure. The relevant factors including clinical manifestations, PDA features, closure procedure and outcome were analyzed and the risk factors were screened with logistic regression analysis. Results The 26 patients with newly diagnosed AR patients or with aggravated AR had significantly higher pulmonary arterial pressure than those without AR ([46.2±20.7] mmHg vs [31.4±17.5] mmHg, 1 mmHg=0.133 kPa), significantly larger left ventricular end diastolic dimension (LVEDD, [5.2±0.2] cm vs [4.2±0.4] cm), significantly more severe PDA ([14.0±6.4] cm vs [9.0±3.5] cm) and significantly higher incidence of preoperative mild AR (38.46% [10/26] vs 18.67% [14/75]) (all P<0.05). Logistic regression analysis demonstrated that LVEDD (OR=33.541, 95% CI 5.883-191.235, P=0.000) and PDA diameter (OR=7.512, 95% CI 1.976-28.564, P=0.003) were the independent predictive factors for AR. During follow-up, 22 (84.62%) AR patients regained aortic valvar competence, and one died of AR deterioration and heart failure at the 30th months. Conclusion It is more possible for the patients with larger LVEDD and severer PDA to develop AR. Most AR patients have a better outcome.