Estimation of haemodynamics parameters to transcatheter closure of patent ductus arteriosus complicated severe pulmonary arterial hypertension

Objective The present study aims to explore the value of haemodynamic parameters in predicting the outcome of transcatheter ductus closure in patients with PDA and severe PAH. Methods Between April 2006 and February 2011, 63 patients with PDA and severe PAH underwent transcatheter closure of PDA. Before percutaneous ductus closure, systolic pulmonary arterial pressure (sPAP) ≥70 mm Hg and pulmonary capillary wedge pressure ≤15 mm Hg and those who underwent cardiac catheterisation under local anaesthesia were included in this study. According to postclosure sPAP, patients were divided into three groups: Group A : patients with sPAp Group B : patients with sPAP ranged from 40 to 70 mm Hg and Group C : patients with sPAP >70 mm Hg after PDA closure. Results A total of 63 patients (49 females) aged from 10 to 60 (32.1±13.8) years were recruited into this study. There was no significant differences in the age and the size of PDA between groups. The sPAP (83±14 vs 99±20 vs 114±14 mm Hg; p 2 ), pulmonary-to-systemic vascular resistance (Rp/Rs) ratio (0.13±0.06 vs 0.31±0.2) were not statistically different between group A and group B, they were significantly lower or higher than those in group C, which were 1.58±0.67, 12.64±3.19 Wood U/m 2 and 0.70±0.24, respectively. And the cardiac Index (14.68±4.98 vs 10.04±4.49 vs 3.99±0.71 l/m 2 /min) decreased significantly from group A to group C. Multiple linear regression analysis showed a significant correlation between the decrease in mPAP after device closure and the baseline EDVI, Pp/Ps ratio and Rp/Rs ratio (p