Sabri Mohammad Reza, Mahdavi Chehreh, Bigdelian Hamid, Ahmadi Ali Reza, Ghaderian Mehdi, Dehghan Bahar, Ramezani Nezhad Davood
Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiovascular Research Institute, Interventional Cardiology Research Center, Isfahan University of Medical Sciences, Iran.
SAGE Open Med Case Rep. 2025 May 14;13:2050313X251336987. doi: 10.1177/2050313X251336987. eCollection 2025.
There is growing evidence of left ventricular decompensation following the closure of the patent ductus arteriosus, which most often happens early in the post-surgical time and improves on its own a few months after. Here, we aim to present nine cases whose left ventricular ejection fraction deteriorated early or late after the procedure. There were nine patients diagnosed with patent ductus arteriosus by echocardiography. The patients presented with a murmur, easy fatigability, exercise intolerance, and poor weight gain. The age varied from 5 months to 41 years old. Patients developed left ventricular ejection fraction deterioration, starting from the day after the operation to 3 years after the closure. Pre-closure left ventricular ejection fraction ranged from 60% to 75% and post-closure from 33% to 59%. The range for shortening fraction (SF) was from 30% to 42% and 16% to 31%, respectively. The patent ductus arteriosus was moderate to large in all patients. One patient was finally diagnosed with dilated cardiomyopathy. Patients with patent ductus arteriosus show left ventricular ejection fraction deterioration up to years after closure, whether percutaneous or operative. Large patent ductus arteriosus is associated with more complications and reduced post-surgery cardiac function due to the amount of the shunt before closure.
越来越多的证据表明，动脉导管未闭闭合后会出现左心室失代偿，这种情况最常发生在术后早期，并在几个月后自行改善。在此，我们旨在介绍9例在该手术后左心室射血分数早期或晚期恶化的病例。有9例患者经超声心动图诊断为动脉导管未闭。这些患者表现为杂音、易疲劳、运动不耐受和体重增加缓慢。年龄从5个月至41岁不等。患者出现左心室射血分数恶化，从术后第二天至闭合后3年。闭合前左心室射血分数范围为60%至75%，闭合后为33%至59%。缩短分数（SF）范围分别为30%至42%和16%至31%。所有患者的动脉导管未闭均为中度至重度。1例患者最终被诊断为扩张型心肌病。无论经皮还是手术治疗，动脉导管未闭患者在闭合后数年都会出现左心室射血分数恶化。由于闭合前分流的量，大型动脉导管未闭与更多并发症和术后心脏功能降低有关。
