Follow-up of Transcatheter Closure of Congenital Heart Disease Complicated with Pulmonary Arterial Hypertension in Children

Huang, Yanyun; Chen, Yuting; Su, Danyan; Qin, Suyuan; Chen, Cheng; Liu, Dongli; Ye, Bingbing; Huang, Yuqin; Yuan, Piaoliu; Pang, Yusheng

doi:10.3389/fped.2025.1562782

ORIGINAL RESEARCH article

Front. Pediatr.

Sec. Pediatric Cardiology

Volume 13 - 2025 | doi: 10.3389/fped.2025.1562782

This article is part of the Research Topic Surgical and Non-Surgical Intervention of Congenital Heart Disease Management in Developing and Developed Countries View all 6 articles

Follow-up of Transcatheter Closure of Congenital Heart Disease Complicated with Pulmonary Arterial Hypertension in Children

Provisionally accepted

Yanyun Huang

Yuting Chen

Danyan Su

Suyuan Qin

Cheng Chen

Dongli Liu

Bingbing Ye

Yuqin Huang

Piaoliu Yuan

Yusheng Pang ^*

First Affiliated Hospital, Guangxi Medical University, Nanning, China

The final, formatted version of the article will be published soon.

Background: Transcatheter closure is now the preferred treatment for congenital heart disease complicated with pulmonary arterial hypertension (CHD-PAH), but its long-term effects are not well understood. We aimed to assess the safety, effectiveness, and outcome of this procedure in children with CHD-PAH.We included 210 children with CHD-PAH at our hospital from 2012 to 2021 and collected their general, laboratory, echocardiographic, and hemodynamic data for analysis. A logistic regression analysis identified risk factors for persistent postclosure PAH (PP-PAH).Results: Among the 210 patients, 84.29% had mild PAH, 8.57% had moderate PAH, and 7.14% had severe PAH. The device was successfully implanted in 98.10% of patients. Early adverse events occurred in 12.14% (n = 25) of patients, with residual shunts and arrhythmia being the most common complications, each affecting 2.91% (n = 6) of patients. Most complications were minor and temporary, except for two cases of residual shunt-one required surgical repair, and one case of complete left bundle branch block led to occluder removal. Postintervention, pulmonary arterial pressure (PAP) decreased significantly, and cardiomegaly resolved. PP-PAH was detected in 13 patients (6.31%). Preoperative pulmonary arterial systolic pressure (odds ratio [OR] = 1.033, 95% confidence interval [CI] = 1.005-1.061, P = 0.019) and right ventricular diameter (OR = 1.111, 95% CI = 1.039-1.187, P = 0.002) were found to be risk factors for PP-PAH. Conclusion: Transcatheter closure is effective and safe for children with correctable CHD-PAH. Preoperative pulmonary arterial systolic pressure and right ventricular diameter 3 are risk factors for PP-PAH.

Keywords: Transcatheter closure, pulmonary arterial hypertension, congenital heart disease, Children, follow-up

Received: 18 Jan 2025; Accepted: 24 Feb 2025.

Copyright: © 2025 Huang, Chen, Su, Qin, Chen, Liu, Ye, Huang, Yuan and Pang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yusheng Pang, First Affiliated Hospital, Guangxi Medical University, Nanning, China

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