| Preclosure pressure gradients predict patent ductus arteriosus patients at risk for later left pulmonary artery stenosis. | |
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MedLine Citation:
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PMID: 19365650 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The objective of this study was to evaluate the incidence of pre-existing catheterization left pulmonary artery (LPA) gradients and correlation of these gradients with later LPA stenosis after successful patent ductus arteriosus (PDA) occlusion. We performed a single-center review of 130 patients with PDA closure from October 1993 to February 2005. We analyzed the pre-PDA closure LPA pressure gradients at catheterization to determine if these were predictive of late LPA stenosis. On follow-up, a V (max) >2 m/s by echocardiogram (transthoracic echocardiography; TTE) was considered indicative of possible LPA stenosis. Left lung perfusion of <35% was considered diagnostic of significant LPA stenosis. Post PDA closure, possible LPA stenosis by TTE was seen in 8 of 128 patients (6.25%). Seven of these eight had precatheter LPA gradients >7 mm Hg. Five of these had perfusion scans, three of the five had significant LPA stenosis, and two underwent LPA angioplasty. Patients with LPA catheter gradients >7 mm Hg were more likely to have possible LPA stenosis by TTE, significant LPA stenosis by lung scan, and intervention with LPA angioplasty. In conclusion, a preclosure main pulmonary artery-to-LPA pressure gradient >7 mm Hg was found in all patients who developed significant LPA stenosis on follow-up after transcatheter PDA closure. It appears likely that these patients have LPA abnormality rather than stenosis caused by the PDA occlusion device. Patients with preclosure LPA gradients >7 mm Hg should undergo follow-up evaluations for detection of significant stenosis and may require treatment if an important flow abnormality is documented. |
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Authors:
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Srinath T Gowda; Shelby Kutty; Makram Ebeid; Athar M Qureshi; Sarah Worley; Larry A Latson |
Publication Detail:
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Type: Journal Article Date: 2009-04-14 |
Journal Detail:
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Title: Pediatric cardiology Volume: 30 ISSN: 1432-1971 ISO Abbreviation: Pediatr Cardiol Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-25 Completed Date: 2010-01-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 883-7 Citation Subset: IM |
Affiliation:
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Children's Hospital of Michigan, Department of Pediatric Cardiology, Detroit Medical Center, Detroit, MI 48201, USA gsrinath@dmc.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Arterial Occlusive Diseases / etiology*, radionuclide imaging, ultrasonography Blood Flow Velocity* Child Child, Preschool Ductus Arteriosus, Patent / therapy* Echocardiography, Doppler Female Heart Catheterization* Humans Infant Male Middle Aged Predictive Value of Tests Pulmonary Artery* / radionuclide imaging, ultrasonography Pulmonary Circulation Retreatment Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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