[III-OR33-04] Myanmar Experience of Transcatheter closure of PDA with near systemic pulmonary arterial pressure
キーワード：PDA, pulmonary hypertension, Myanmar
Background:In Myanmar, we often see patients having Patent Ductus Arteriosus (PDA) with near systemic PH and deciding them for transcatheter closure(TCC) is challenging. Objective:To share Myanmar experience of TCC of PDA with PH. Methods:Retrospective study. We reviewed demographic data and clinical findings and catheterization procedures of 16 children with PDA and PASP≧80% of Systolic Blood Pressure(SBP) who underwent TCC at YKCH, Myanmar from August 2015 to August 2017.Results:The mean age at procedure was 5.6yr(range=5m-14 yr).Male to female ratio is 3:13.Mean body weight was 14±7.9kg.Mean PASP is 83±13mmHg.Minimal PDA diameter is 8.8±3.9mm at pulmonary end.Balloon occlusion test was done in one child.Hemodynamic response was observed up to thirty minutes after device indwelling.PASP reduced in 14 children(60±14mmHg) and device closure was succeeded.Various Duct Occluders were used in 7patients and muscular VSD Occluders in 7 patients. In two boys, hemodynamic instability occurred in trial device closure so we abandoned it.All patients were stable after device closure. Success rate of procedure was 88%.Recheck echo was done in next day,1m, 3m and 6m after procedure. No complication occurred. All children improved clinically. Parameters for PHT found reduced in recheck echo.Conclusion:TCC of large PDA with high PASP is feasible, effective and relatively safe as far as we experienced.