title: Differential pulmonary perfusion scan after percutaneous occlusion of the patent ductus arteriosus: one-decade consecutive longitudinal study from a single institution.
abstract: Reduced left lung perfusion has been described following percutaneous occlusion of the patent ductus arteriosus (PDA). We aimed to identify the incidence of lung perfusion abnormalities and the associated risk factors in our consecutive series. Between November 1994 and December 2003, 150 procedures were performed on 145 patients, age 4.6 +/- 4 years. Gianturco coil was used in 88.2%, Amplatzer duct occluder in 6.7%, and Rashkind Umbrella in 5.5%. Lung perfusion scan was scheduled within 48 h (LPS-1), at 6-12 months (LPS-2) and later (LPS-3) in the case of persistent abnormalities. Left lung perfusion <40% was considered abnormal. LPS-1 was obtained in 95.8% and was abnormal in 31%. LPS-2, available in 48.2%, returned to normal in 65.7% (p < 0.001). LPS-3, required in 6.2%, was normal in 55.6% (p = 0.07). Identifiable risk factors were low age and height (p < 0.01), higher Q(p)/Q(s) ratio (p < 0.05), and larger PDA size indexed for height (p < 0.001) or body surface area (p < 0.01). The number of coils or loops deployed in the pulmonary end of the PDA did not influence lung perfusion. In conclusion, we describe a high incidence of left lung perfusion reduction following percutaneous PDA occlusion, more likely in the young with large PDA. However, spontaneous recovery usually occurs within a few months.
authors.affiliation: Institut de Cardiologie d'Abidjan, Abidjan, Côte D'Ivoire.
authors.forename: Euloge Kouadio
authors.initials: EK
authors.lastname: Kramoh
authors.forename: Joaquim
authors.initials: J
authors.lastname: Miró
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bigras
authors.forename: Sophie
authors.initials: S
authors.lastname: Turpin
authors.forename: Raymond
authors.initials: R
authors.lastname: Lambert
authors.forename: Chantal
authors.initials: C
authors.lastname: Lapierre
authors.forename: Weidong
authors.initials: W
authors.lastname: Jin
authors.forename: Nagib
authors.initials: N
authors.lastname: Dahdah
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D015150:Echocardiography, Doppler; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008168:Lung / Q000000981:diagnostic imaging*; D011184:Postoperative Period; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000009:adverse effects*; D011877:Radionuclide Imaging; D012307:Risk Factors