Liao Xiong-Yu, Li Jun-Jie, Zeng Shao-Ying, Zhang Zhi-Wei, Xie Yu-Mei
Department of Cardiology, Children's Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Front Cardiovasc Med. 2025 Jul 9;12:1628666. doi: 10.3389/fcvm.2025.1628666. eCollection 2025.
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.
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.
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.
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.
报告3例成功闭合动脉导管未闭（PDA）合并重度肺动脉高压（PH）的病例，并探讨先天性心脏病（CHD）合并重度PH的介入封堵策略。本研究旨在确定此类患者是否能够接受介入封堵并从中获益，为医生提供临床见解。
对广东省人民医院小儿心脏病科成功通过介入封堵治疗的3例重度PH的小儿PDA病例进行回顾性分析。截至2024年11月，在PubMed和中国知网（CNKI）数据库中检索与“动脉导管未闭”“重度肺动脉高压”“艾森曼格综合征”“靶向治疗”和“介入封堵”（中英文）相关的文献。结合文献分析病例特征和治疗策略。
所有3例小儿患者均患有CHD合并重度PH，在给予至少3个月的内皮素受体拮抗剂或磷酸二酯酶5抑制剂治疗（靶向治疗）后成功进行了PDA封堵。术后继续进行靶向治疗，随访至2024年11月30日。所有病例均未观察到肺动脉压力（PAH）显著升高，运动耐量明显改善。
CHD合并重度PH的儿童在经过一段时间的靶向治疗后可能适合进行介入封堵，并可能从该手术中获益。在封堵前后给予靶向药物不仅为干预提供了机会，还降低了术后持续性PAH的风险。
