open access

Vol 69, No 5 (2011)
Original articles
Published online: 2011-05-18
Submitted: 2012-12-28
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Patent ductus arteriosus at low and high altitudes: anatomical and haemodynamic features and their implications for transcatheter closure

Jacek Białkowski, Jan Głowacki, Carlos Zabal, Antonio Garcia−Montes, Ramon Bermudez−Canete, Ramon Flores−Arizmendi, Antonio Sagado−Sandova, Hernan Diaz de Leon, Ramiro Menacho Delagadillo, Jaqueline Kreutzer
Kardiol Pol 2011;69(5):431-436.

open access

Vol 69, No 5 (2011)
Original articles
Published online: 2011-05-18
Submitted: 2012-12-28

Abstract

Background: Living at high altitude increases the prevalence of patent ductus arteriosus (PDA) and may affect its morphology.
Aim: To compare the anatomical and haemodynamic features of isolated PDA in patients living at low and high altitudes (1,500–4,200 metres above sea level — m.a.s.l.).
Methods: We studied retrospectively data from 1,404 consecutive patients — 708 living in lowland areas (group L) and 696 in highland areas (group H), in whom transcatheter closure of PDA was attempted. The mean age of the patients in group L was 9.9 ± 13.5 years and in group H it was 8.2 ± 19.7 years.
Results: The diameter of PDA in group L was 2.3 ± 1.3 mm and 4.1 ± 1.2 mm in group H (p < 0.001), while the mean pulmonary artery pressure was 17.9 ± 5.9 mm Hg and 25.5 ± 12.3 mm Hg, respectively (p < 0.001). Angiographic PDA type A was more frequently observed in highland patients. In groups L and H, self expanding nitinol occluders (mostly Amplatzer devices) were used in 25.7% vs 92.2% of patients (p < 0.001), whereas coils were used in 69.2% vs 7.5% (p < 0.001), respectively. Double umbrella systems were used in 4.8% of patients in group L.
Conclusions: In catheterised patients with PDA living at high altitude, larger ductal diameter, anatomic type A and higher pulmonary artery pressure were more frequently observed. This finding has important implications for future strategy regarding transcatheter closure in populations living at different altitudes.
Kardiol Pol 2011; 69, 5: 431–436

Abstract

Background: Living at high altitude increases the prevalence of patent ductus arteriosus (PDA) and may affect its morphology.
Aim: To compare the anatomical and haemodynamic features of isolated PDA in patients living at low and high altitudes (1,500–4,200 metres above sea level — m.a.s.l.).
Methods: We studied retrospectively data from 1,404 consecutive patients — 708 living in lowland areas (group L) and 696 in highland areas (group H), in whom transcatheter closure of PDA was attempted. The mean age of the patients in group L was 9.9 ± 13.5 years and in group H it was 8.2 ± 19.7 years.
Results: The diameter of PDA in group L was 2.3 ± 1.3 mm and 4.1 ± 1.2 mm in group H (p < 0.001), while the mean pulmonary artery pressure was 17.9 ± 5.9 mm Hg and 25.5 ± 12.3 mm Hg, respectively (p < 0.001). Angiographic PDA type A was more frequently observed in highland patients. In groups L and H, self expanding nitinol occluders (mostly Amplatzer devices) were used in 25.7% vs 92.2% of patients (p < 0.001), whereas coils were used in 69.2% vs 7.5% (p < 0.001), respectively. Double umbrella systems were used in 4.8% of patients in group L.
Conclusions: In catheterised patients with PDA living at high altitude, larger ductal diameter, anatomic type A and higher pulmonary artery pressure were more frequently observed. This finding has important implications for future strategy regarding transcatheter closure in populations living at different altitudes.
Kardiol Pol 2011; 69, 5: 431–436
Get Citation

Keywords

ductus arteriosus; catheterisation

About this article
Title

Patent ductus arteriosus at low and high altitudes: anatomical and haemodynamic features and their implications for transcatheter closure

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 69, No 5 (2011)

Pages

431-436

Published online

2011-05-18

Bibliographic record

Kardiol Pol 2011;69(5):431-436.

Keywords

ductus arteriosus
catheterisation

Authors

Jacek Białkowski
Jan Głowacki
Carlos Zabal
Antonio Garcia−Montes
Ramon Bermudez−Canete
Ramon Flores−Arizmendi
Antonio Sagado−Sandova
Hernan Diaz de Leon
Ramiro Menacho Delagadillo
Jaqueline Kreutzer

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