Skip to main content
Top
Published in: Journal of Cardiothoracic Surgery 1/2019

Open Access 01-12-2019 | Patent Ductus Arteriosus | Research article

Left ventricular dysfunction postsurgical patent ductus arteriosus ligation in children: predictor factors analysis

Authors: Mohamed Abdel-Bary, Khaled Abdalla Abdel-Baseer, Ahmed Fathy Abdel-Latif, Mohamed Abdella Abdel-Naser, Mahmoud Nafie, Karam Mosallam Eisa

Published in: Journal of Cardiothoracic Surgery | Issue 1/2019

Login to get access

Abstract

Objective

To identify the predictor factors of left ventricular (LV) dysfunction following patent ductus arteriosus (PDA) surgical ligation.

Background

PDA is viewed as a noticeable amongst the most widely recognized congenital heart defects in children and its closure is responsible for many hemodynamic changes that require intervention and care.

Methods

A retrospective study included fifty children with isolated PDA treated by surgical ligation from June 2015 to June 2018. The LV dimensions and systolic function were assessed by two-dimensional echocardiography pre and post PDA ligation. All cases were followed-up on the first-day, 1 month and 6 months post ligation.

Results

The mean age of cases was 15.78 ± 7.58 months and 72% were females. The mean duct size was 4.08 ± 1.25 mm. There was a marked decrease in LVEDd, LA/Ao, EF and FS in the first-day post ligation contrasted with pre ligation values. Moreover, an amazing decline in LVEDd and LA/Ao ratio was observed 1 month post ligation contrasted with the early post ligation status with asynchronous improvement of FS and EF at one and 6 months postoperatively.

Conclusion

PDA ligation is associated with a noteworthy LV systolic dysfunction within the first day post ligation; that in a significant number of patients may require anti-failure measures, prolong the hospital stay and necessitate a regular follow up and monitoring of LV function. PDA size, age, preoperative LVEDd and FS can be considered as predictor factors for suspicion of acute decrease in the LV systolic function early post PDA ligation.

Trial registration

ClinTrial.Gov NCT04018079.
Literature
1.
go back to reference Leonhardt A, Glaser A, Wegmann M, Schranz D, Seyberth H, Nüsing R. Expression of prostanoid receptors in human ductus arteriosus. Br J Pharmacol. 2003;138:655–9.CrossRef Leonhardt A, Glaser A, Wegmann M, Schranz D, Seyberth H, Nüsing R. Expression of prostanoid receptors in human ductus arteriosus. Br J Pharmacol. 2003;138:655–9.CrossRef
2.
go back to reference Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A. Prevalence of congenital heart defects in metropolitan Atlanta, 1998–2005. J Pediatr. 2008;153:807–13.CrossRef Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A. Prevalence of congenital heart defects in metropolitan Atlanta, 1998–2005. J Pediatr. 2008;153:807–13.CrossRef
4.
go back to reference Schneider DJ. The patent ductus arteriosus in term infants, children, and adults. Semin Perinatol. 2012;36:146–53.CrossRef Schneider DJ. The patent ductus arteriosus in term infants, children, and adults. Semin Perinatol. 2012;36:146–53.CrossRef
5.
go back to reference Sehgal A, McNamara PJ. International perspective on management of a patent ductus arteriosus: lessons learned. Semin Fetal Neonatal Med. 2018;23(4):278–84.CrossRef Sehgal A, McNamara PJ. International perspective on management of a patent ductus arteriosus: lessons learned. Semin Fetal Neonatal Med. 2018;23(4):278–84.CrossRef
6.
go back to reference Jeong YH, Yun TJ, Song JM, Park JJ, Seo DM, Koh JK, et al. Left ventricular remodelling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure. Am Heart J. 2007;154:436–40.CrossRef Jeong YH, Yun TJ, Song JM, Park JJ, Seo DM, Koh JK, et al. Left ventricular remodelling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure. Am Heart J. 2007;154:436–40.CrossRef
7.
go back to reference Weisz DE, More K, McNamara PJ, Shah PS. PDA ligation and health outcomes: a meta-analysis. Pediatrics. 2014;133:e1024.CrossRef Weisz DE, More K, McNamara PJ, Shah PS. PDA ligation and health outcomes: a meta-analysis. Pediatrics. 2014;133:e1024.CrossRef
8.
go back to reference Ulrich TJ, Hansen TP, Reid KJ, Bingler MA, Olsen SL. Post-ligation cardiac syndrome is associated with increased morbidity in preterm infants. J Perinatol. 2018;38:537–42.CrossRef Ulrich TJ, Hansen TP, Reid KJ, Bingler MA, Olsen SL. Post-ligation cardiac syndrome is associated with increased morbidity in preterm infants. J Perinatol. 2018;38:537–42.CrossRef
9.
go back to reference El-Khuffash AF, Jain A, Weisz D, Mertens L, McNamara PJ. Assessment and treatment of post patent ductus arteriosus ligation syndrome. J Pediatr. 2014;165(1):46–52.CrossRef El-Khuffash AF, Jain A, Weisz D, Mertens L, McNamara PJ. Assessment and treatment of post patent ductus arteriosus ligation syndrome. J Pediatr. 2014;165(1):46–52.CrossRef
11.
go back to reference Saida K, Nakamura T, Hiroma T, Takigiku K, Yasukochi S. Preoperative left ventricular internal dimension in end-diastole as earlier identification of early patent ductus arteriosus operation and postoperative intensive care in very low birth weight infants. Early Hum Dev. 2013;89(10):821–3.CrossRef Saida K, Nakamura T, Hiroma T, Takigiku K, Yasukochi S. Preoperative left ventricular internal dimension in end-diastole as earlier identification of early patent ductus arteriosus operation and postoperative intensive care in very low birth weight infants. Early Hum Dev. 2013;89(10):821–3.CrossRef
12.
go back to reference Rubio M, Wiegman A, Naeff M. ICRF-187 (Cardioxane®) protection against doxorubicin induced cardiomyopathy in paediatric osteosarcoma patients. [abstract]. Proc Am Soc Clin Oncol. 1995;14:A440. Rubio M, Wiegman A, Naeff M. ICRF-187 (Cardioxane®) protection against doxorubicin induced cardiomyopathy in paediatric osteosarcoma patients. [abstract]. Proc Am Soc Clin Oncol. 1995;14:A440.
13.
go back to reference Gupta SK, Krishnamoorthy K, Tharakan JA, Sivasankaran S, Sanjay G, Bijulal S, et al. Percutaneous closure of patent ductus arteriosus in children: immediate and short-term changes in left ventricular systolic and diastolic function. Ann Pediatr Cardiol. 2011;4:139–44.CrossRef Gupta SK, Krishnamoorthy K, Tharakan JA, Sivasankaran S, Sanjay G, Bijulal S, et al. Percutaneous closure of patent ductus arteriosus in children: immediate and short-term changes in left ventricular systolic and diastolic function. Ann Pediatr Cardiol. 2011;4:139–44.CrossRef
14.
go back to reference Galal MO, Amin M, Hussein A, Kouatli A, Al-Ata J, Jamjoom A. Left ventricular dysfunction after closure of large patent ductus arteriosus. Asian Cardiovasc Thorac Ann. 2005;13:24–9.CrossRef Galal MO, Amin M, Hussein A, Kouatli A, Al-Ata J, Jamjoom A. Left ventricular dysfunction after closure of large patent ductus arteriosus. Asian Cardiovasc Thorac Ann. 2005;13:24–9.CrossRef
15.
go back to reference SA E-s, WS E-S. Could the size of ductus arteriosus be an independent predictor for the changes in left ventricular function post percutaneous closure! Evaluation by tissue Doppler and speckle-derived strain rate echocardiography. Int J Cardiovasc Res. 2017;6:5.CrossRef SA E-s, WS E-S. Could the size of ductus arteriosus be an independent predictor for the changes in left ventricular function post percutaneous closure! Evaluation by tissue Doppler and speckle-derived strain rate echocardiography. Int J Cardiovasc Res. 2017;6:5.CrossRef
16.
go back to reference Kim YH, Choi HJ, Cho Y, Lee SB, Hyun MC. Transient left ventricular dysfunction after percutaneous patent ductus arteriosus closure in children. Korean Circ J. 2008;38(11):596–600.CrossRef Kim YH, Choi HJ, Cho Y, Lee SB, Hyun MC. Transient left ventricular dysfunction after percutaneous patent ductus arteriosus closure in children. Korean Circ J. 2008;38(11):596–600.CrossRef
17.
go back to reference Elsheikh RG, Hegab MS, Salama MM, Elseteha M, Omar AI. Echocardiograpic evaluation of short-term outcome of patent ductus arteriosus closure using Amplatzer Occluder device. J Cardiovasc Dis Diagn. 2015;3:220.CrossRef Elsheikh RG, Hegab MS, Salama MM, Elseteha M, Omar AI. Echocardiograpic evaluation of short-term outcome of patent ductus arteriosus closure using Amplatzer Occluder device. J Cardiovasc Dis Diagn. 2015;3:220.CrossRef
18.
go back to reference Eerola A, Jokinen E, Boldt T, Pihkala J. The influence of percutaneous closure of patent ductus arteriosus on left ventricular size and function: a prospective study using two and three-dimensional echocardiography and measurements of serum natriuretic peptides. J Am Coll Cardiol. 2006;47:1060–6.CrossRef Eerola A, Jokinen E, Boldt T, Pihkala J. The influence of percutaneous closure of patent ductus arteriosus on left ventricular size and function: a prospective study using two and three-dimensional echocardiography and measurements of serum natriuretic peptides. J Am Coll Cardiol. 2006;47:1060–6.CrossRef
19.
go back to reference Hussain BK, Shaikh AS, Sohail A, Naresh KC, Veena K, Muhammad AK, et al. Predictors for left ventricular systolic dysfunction and its outcome after patent ductus arteriosus (Pda) closure by device. Int J Cardiovasc Res. 2018;7:1. Hussain BK, Shaikh AS, Sohail A, Naresh KC, Veena K, Muhammad AK, et al. Predictors for left ventricular systolic dysfunction and its outcome after patent ductus arteriosus (Pda) closure by device. Int J Cardiovasc Res. 2018;7:1.
20.
go back to reference Kiran VS, Tiwari A. Prediction of left ventricular dysfunction after device closure of patent ductus arteriosus: proposal for a new functional classification. EuroIntervention. 2018;13(18):e2124–9.CrossRef Kiran VS, Tiwari A. Prediction of left ventricular dysfunction after device closure of patent ductus arteriosus: proposal for a new functional classification. EuroIntervention. 2018;13(18):e2124–9.CrossRef
21.
go back to reference Agha HM, Hamza HS, Kotby A, Ganzoury MEL, Soliman N. Predictors of transient left ventricular dysfunction following transcatheter patent ductus arteriosus closure in pediatric age. J Saudi Heart Assoc. 2017;29:244–51.CrossRef Agha HM, Hamza HS, Kotby A, Ganzoury MEL, Soliman N. Predictors of transient left ventricular dysfunction following transcatheter patent ductus arteriosus closure in pediatric age. J Saudi Heart Assoc. 2017;29:244–51.CrossRef
22.
go back to reference Patole SK, Muller R. Enteral feeding of preterm neonates: a survey of Australian neonatologists. J Matern Fetal Neonatal Med. 2004;16(5):309–14.CrossRef Patole SK, Muller R. Enteral feeding of preterm neonates: a survey of Australian neonatologists. J Matern Fetal Neonatal Med. 2004;16(5):309–14.CrossRef
23.
go back to reference Amoogzar H, Shakiba AM, Derakhshan D, Ajami G, Cheriki S, Borzouee M, et al. Evaluation of left ventricular function by tissue Doppler and speckle-derived strain rate echocardiography after percutaneous ductus closure. Pediatr Cardiol. 2015;36:219–25.CrossRef Amoogzar H, Shakiba AM, Derakhshan D, Ajami G, Cheriki S, Borzouee M, et al. Evaluation of left ventricular function by tissue Doppler and speckle-derived strain rate echocardiography after percutaneous ductus closure. Pediatr Cardiol. 2015;36:219–25.CrossRef
Metadata
Title
Left ventricular dysfunction postsurgical patent ductus arteriosus ligation in children: predictor factors analysis
Authors
Mohamed Abdel-Bary
Khaled Abdalla Abdel-Baseer
Ahmed Fathy Abdel-Latif
Mohamed Abdella Abdel-Naser
Mahmoud Nafie
Karam Mosallam Eisa
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2019
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-019-0990-z

Other articles of this Issue 1/2019

Journal of Cardiothoracic Surgery 1/2019 Go to the issue