Xiong-Yu Liao, Jun-Jie Li, Shao-Ying Zeng, Zhi-Wei Zhang, Yu-Mei Xie
Children’s Medical Center, Sun Yat-sen Memorial Hospital and Sun Yat-sen University. Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences) and Southern Medical University.
China
Fontiers in Cardiovascular Medicine
Front Cardiovasc Med 2025;
DOI: 10.3389/fcvm.2025.1628666
Abstract
Purpose: To report three cases of successful closure of patent ductus arteriosus (PDA) with severe pulmonary hypertension (PH) and explore interventional closure strategies for congenital heart disease (CHD) complicated by severe PH. This study aims to determine whether such patients can undergo and benefit from interventional closure, providing clinical insights for physicians.
Methods: A retrospective analysis was conducted on three pediatric cases of PDA with severe PH successfully treated via interventional closure at the Department of Pediatric Cardiology, Guangdong Provincial People’s Hospital. Literature related to “patent ductus arteriosus,” “severe pulmonary hypertension,” “Eisenmenger syndrome,” “targeted therapy,” and “interventional closure” (in both Chinese and English) was searched in PubMed and the China National Knowledge Infrastructure (CNKI) database up to November 2024. Case characteristics and therapeutic strategies were analyzed in conjunction with the literature.
Results: All three pediatric patients had CHD combined with severe PH and underwent successful PDA occlusion after administration of at least 3 months of endothelin receptor antagonist or PDE5 inhibitor therapy (targeted therapy). Postoperative targeted therapy was continued, with follow-up until November 30, 2024. No significant elevation in pulmonary artery pressure (PAH) was observed, and exercise tolerance markedly improved in all cases.
Conclusion: Children with CHD and severe PH may qualify for interventional closure after a period of targeted therapy and could benefit from this procedure. Administering targeted medications before and after closure not only provides opportunities for intervention but also reduces the risk of persistent postoperative PAH.
Category
Class I. Pulmonary Hypertension Associated with Congenital Cardiovascular Disease
Medical Therapy. Efficacy or Lack of Efficacy
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes