Archives of the Turkish Society of Cardiology
Characteristics and transcatheter closure of patent ductus arteriosus in patients living at moderate-to-high altitude in Eastern Anatolia [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-20805 | DOI: 10.5543/tkda.2019.20805

Characteristics and transcatheter closure of patent ductus arteriosus in patients living at moderate-to-high altitude in Eastern Anatolia

Serdar Epçaçan1, Mustafa Orhan Bulut2, Yüksel Kaya3, Ilker Kemal Yücel2, Çayan Çakır4, Emrah Şişli5, Yemlihan Ceylan6, Ahmet Çelebi2
1University of Medical Sciences, Van Education and Research Hospital, Department of Pediatric Cardiolgy, Van, Turkey
2University of Medical Sciences, Dr. Siyami Ersek Hospital for Cardiology and Cardiovascular Surgery, Department of Pediatric Cardiology, Istanbul, Turkey
3Yuzuncu Yil University, Medical Faculty, Department of Cardiology, Van, Turkey.
4University of Medical Sciences, Van Training and Research Hospital, Department of Cardiology, Van, Turkey.
5University of Medical Sciences, Van Training and Research Hospital, Department of Pediatric Cardiovascular Surgery, Van, Turkey.
6Lokman Hekim Hospital, Department of Cardiology, Van, Turkey

Background and
OBJECTIVE
Patent ductus arteriosus (PDA) has a high incidence, is larger and associated with elevated pulmonary hypertension in patients living at high altitude. The aim of this study is to evaluate the hemodynamic and morphological features of PDA and also investigate the transcatheter closure procedures with various devices in this group.

METHODS
A total of 327 patients, living at an altitude of at least 1600 meters above sea level and undergone cardiac catheterization for isolated PDA between May 2010 and July 2018, were analyzed.

RESULTS
The mean age was 7.33±7.67 years, 62.4% of the patients were females. The mean ductal diameter was 3.74±2.14 mm. 57.8% of the patients had pulmonary hypertension. Transcatheter closure were performed in 322 patients with a %97.3 success rate. Amplatzer duct occluder I was the most used device. Amplatzer vascular plug (AVP) II and Amplatzer muscular ventricular septal defect occluder (AMVSDO) was the used off-label devices. Pulmonary artery pressure decreased immediately in the vast majority after percutaneous closure. Transient left ventricular systolic dysfunction after ductal closure was observed rarely. Follow-up course was uneventful.

CONCLUSION
Transcatheter PDA closure can be performed with high success rate in highlanders. Device embolization is mostly seen in patients with type A duct. Oversizing the device may reduce the incidence of device embolization. Off-label devices such as AVP II and AMVSDO can be safely used in these patients. Transient left ventricular dysfunction is rarely seen in these patients but mostly impairs without any medication.

Keywords: High altitude, pulmonary hypertension, patent ductus arteriosus, transcatheter closure

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Corresponding Author: Serdar Epçaçan, Türkiye
© Copyright 2019 Archives of the Turkish Society of Cardiology
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