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High haemoglobin levels at the time of occlusion predict worse outcome for patients with patent ductus arteriosus and pulmonary hypertension

Published online by Cambridge University Press:  11 August 2022

Kanta Kishi ,
Jirayut Jarutach ,
Yinn Khurn Ooi ,
Ngie Liong Wong ,
Marhisham Che Mood ,
Geetha Kandhavello ,
Mazeni Alwi  and
Ming Chern Leong Open the ORCID record for Ming Chern Leong [Opens in a new window]
Kanta Kishi
Affiliation:
Division of Cardiology, Department of Paediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
Jirayut Jarutach
Affiliation:
Division of Cardiology, Department of Paediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Yinn Khurn Ooi
Affiliation:
Paediatric Department, Cardiology Unit, Serdang Hospital, 43000 Serdang, Selangor, Malaysia
Ngie Liong Wong
Affiliation:
Department of Cardiology, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, Kuching 93596, Sarawak, Malaysia
Marhisham Che Mood
Affiliation:
Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
Geetha Kandhavello
Affiliation:
Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
Mazeni Alwi
Affiliation:
Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
Ming Chern Leong*
Affiliation:
Paediatric & Congenital Heart Centre, Institut Jantung Negara (National Heart Institute), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
*
Author for correspondence: Dr Ming Chern Leong, Paediatric & Congenital Heart Centre, Institut Jantung Negara, 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia. Tel: +603 2617 8470; Fax: +603 2694 6478. E-mail: mcleong@ijn.com.my
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Abstract

Introduction:

Current guidelines discourage shunt closure in patients with pulmonary vascular resistance index >8 Wood units x m2. The study examined the long-term outcome of patients over 15 years old, with pulmonary vascular resistance index >8 Wood units x m2 and patent ductus arteriosus.

Materials and methods:

This was a multi-institutional, retrospective study involving all consecutive patients (>15 years old) with patent ductus arteriosus and severe pulmonary hypertension. Patients who had patent ductus arteriosus closure were divided into the Good (no death or hospital admissions due to worsening pulmonary hypertension) and the Poor Outcome groups and these groups were compared.

Results:

Thirty-seven patients [male: 9 (24.3%); mean age: 30.49 ± 9.56 years; median follow-up: 3 (IQR: 1.5,10) years] were included from four centers. Twenty-two patients who underwent patent ductus arteriosus closure, 15 (71.4%) had good outcomes while 7 (28.6%) had poor outcomes. Pulmonary vascular resistance index and pulmonary to systemic resistance ratio (Rp:Rs) were lower in the Good Outcome Group (14.35 ± 1.66 Wood units x m2 vs. 20.07 ± 2.44; p = 0.033 and 0.44 ± 0.16 vs. 1.08 ± 1.21; p = 0.042). Haemoglobin concentrations (<14.3 g/dL) were associated with good long-term outcomes in the Closed Group.

Conclusions:

Patients with patent ductus arteriosus with severe pulmonary hypertension have a dismal outcome with or without closure. High haemoglobin levels at the time of occlusion predict a worse outcome for patients with patent ductus arteriosus and pulmonary hypertension.

Keywords

Patent ductus arteriosuspulmonary hypertensionlong-term outcome
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 8 , August 2023 , pp. 1359 - 1366
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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