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| Comparative study of features and interventional treatment of macro-diameter patent ductus arteriosus at different altitude areas |
| LU Qiang1,2,WU Xiaoxia3,MA Dongxing2,FAN Meiqun1,HOU Haijun3,LI Hui4 |
1.Chinese People’s Armed Police Force Clinical of Anhui Medical University,Beijing 100039, China;
2. The Department of Cardiology;
3. The Department of Ultrasound;
4.The department of tvophology, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China |
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Abstract Objective To study the safety and efficacy of interventional treatment of macro-diameter patent ductus arteriosus(PDA) at high altitude and in plain areas. Methods From April 2011 to September 2013, 73 macro-diameter PDA sufferers who came from high altitude region of Tibet (higher than3,500 metres) were as the high altitude group, and 28 patients came from low altitude region of Fujian (lower than 2,000 metersin) were as the low altitude group. Interventional occlusion operations werdone with the home made blockers, then were followed up by means of, ultrasonic cardiograms and electrocardiogram for 3 months to evaluate the efficacy. The features, intervention treatment outcome and postoperative complications of macro-diameter PDA were observed in the both groups. Results At high altitude, macro-diameter PDA accounted for 42.20%, the mean diameter of PDA was (17?8.36)mm, markedly bigger than in the low altitonde group(P<0.05), and the pulmonary arterial pressure was (76.8?18.32) mmHg, higher than that in the other group(P<0.05). At low altitude, angiography showed that there were 28 macro-diameter PDA patients, the mean diameter of PDA was (13?2.41 )mm, and the pulmonary arterial pressure by right heart catheterisation was (30.87?14.68) mmHg, then the mushroom cap occluder with 23?6 mm in diameter was chosen. The success rate of interventional operation for the high-altitude group was 97.60% (2 cases failed), while for the low-altitude group was 100%. There were 10 cases of postoperative residual shunt cases in high altimde group, 6 cases in the high-altitude group, while 4 cases in the low-altitude group. There were cases of thrombopenia of whom one improved after removing the ouluder in the high-altitude group;two cases of thrombopenia in the low-altitude group; and no death. Conclusion The macro-diameter patent ductus arteriosus and complicated pulmonary hypertension in the high altitude areas is more in number and heavier, and the effect of pulmonary hypertension on interventional operation security is smaller than in the patients from lower altitudes. The macro-diameter PDA occluder (PDA narrowest diameter?1.5 ~ PDA narrowest diameter?2) is selected by recommendation. We should pay attention to simple thrombocytopenia, and no residual shunt after occlusion is also the key to avoid complications and ensure success for the interventional treatment.
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Received: 28 October 2013
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2014, Vol. 25 
