title: Left ventricular dysfunction after closure of large patent ductus arteriosus.
abstract: Changes in left ventricular dimensions and performance were studied in 43 patients after transcatheter occlusion or surgical ligation of patent ductus arteriosus. The patients were assigned to 2 groups based on their ductal diameter: >/= 3.1 mm to group A (n = 27) and </= 3 mm to group B (n = 16). The mean age and weight of the groups were comparable. Before intervention, group A had a significantly larger mean left ventricular end-diastolic diameter than group B, while all patients had normal shortening fraction and ejection fraction. Within 1 month after intervention, left ventricular end-diastolic diameter showed a trend towards regression while shortening fraction and ejection fraction decreased significantly in group A. There were no significant changes in these parameters in group B. Between 1 and 6 months after intervention, left ventricular performance improved in most of the group A patients who were followed up. We conclude that closure of large ductus arteriosus in children leads to significant immediate deterioration of left ventricular performance, which appears to recover within a few months. Echocardiographic study before hospital discharge is recommended in these patients. Serious deterioration of ventricular performance after closure may warrant the use of angiotensin converting enzyme inhibitors.
authors.affiliation: Cardiovascular Department, MBC J 16, King Faisal Specialist Hospital and Research Centre, P.O. Box 40047, Jeddah 21499, Saudi Arabia. ogalal@yahoo.com
authors.forename: M Omar
authors.initials: MO
authors.lastname: Galal
authors.forename: Mohamed
authors.initials: M
authors.lastname: Amin
authors.forename: Arif
authors.initials: A
authors.lastname: Hussein
authors.forename: Amjad
authors.initials: A
authors.lastname: Kouatli
authors.forename: Jameel
authors.initials: J
authors.lastname: Al-Ata
authors.forename: Ahmed
authors.initials: A
authors.lastname: Jamjoom
mesh_terms: D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology