Echocardiographic assessment of patients with patent ductus arterious living in regions of different altitude after being treated with transcatheter obliteration

Objective　To evaluate the practical value of transthoracic echocardiography (TTE) in transcatheter treatment in patients with patent ductus arterious (PDA) living in regions of different altitude. Methods　Three hundred and fifty-three patients with PDA who had undergone TTE examination were divided into two groups, 115 patients in high altitude group (living in regions higher than 3600m) and 238 patients in low altitude group (living in regions lower than 800m). The pattern, diameter and length of PDA were determined by TTE (Vivid 7), and the therapeutic effect was assessed 3~5 days, and 3, 6 and 12 months after closure. Results　Thirty patients were found to have other congenital heart diseases. Transcatheter closure was successful in 346 patients, and the success rate of operation was 98.0%. Compared with that before operation, the left ventricular diameter and left ventricular ejection fraction (LVEF) were decreased significantly after closure (P<0.05). The LVEF in 19 patients was decreased to less than 50%, including 14 patients living in high altitude regions and 5 patients living in low altitude regions. Of 36 patients whose systolic pulmonary pressure was over 70mmHg, 32 underwent closure successfully and their systolic pulmonary pressure decreased more than 30mmHg after operation. Residual shunt was found in 13 patients. Out of these patients, the occluder was removed in 1 by surgery, and the residual shunt disappeared in 7 patients 3 months later. The occluders in 12 patients were larger than 50% of the diameter of descending aorta. Increased flow rate in the descending aorta was found in one of the 12 patients. Conclusion　 Echocardiography is a valuable method in screening the PDA patients living in regions of different altitude before transcatheter therapy, and also for evaluating the therapeutic effects after the operation. DOI: 10.11855/j.issn.0577-7402.2013.11.014