Open Access

ARTICLE

Isolated Closure versus Mitral Valvuloplasty for Patent Ductus Arteriosus in Patients with Mitral Regurgitation: A Single-Center, Retrospective Study

Jiaqing Tang^1,2, Yushen Fang^1,2, Jiahong Li^2,3, Zechen Li^1,2, Zhuyang Yang^2,3, Huiru Xie^2,4, Miao Tian^1,2,3, Zhanhao Su^1,2,3, Shusheng Wen^1,2,3, Xiaohua Li^1,2,3,*, Haiyun Yuan^1,2,3,4,*
1 Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
2 Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China
3 Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
4 School of Medicine, South China University of Technology, Guangzhou, China
* Corresponding Author: Xiaohua Li. Email: ; Haiyun Yuan. Email:

Structural and Congenital Heart Disease https://doi.org/10.32604/schd.2026.080591

Received 12 February 2026; Accepted 09 September 2026; Published online 20 September 2026

Abstract

Background: Patent ductus arteriosus (PDA) can cause left-heart volume overload and functional mitral regurgitation (MR), although some patients have structural mitral abnormalities requiring repair. We compared MR and cardiac remodeling after isolated PDA closure and PDA closure combined with mitral valvuloplasty (MVP). Methods: This single-center retrospective study included 68 children treated between February 2013 and February 2025: isolated PDA transcatheter occlusion (IPTO, n = 34), isolated PDA surgical ligation (IPSL, n = 20), and PDA ligation with concomitant mitral valvuloplasty (PLMVP, n = 14). Body-size-adjusted cardiac dimensions were analyzed at baseline and discharge, while MR outcomes were assessed at the latest follow-up. Linear mixed-effects models evaluated temporal changes, and Analysis of Covariance (ANCOVA) assessed net MR-area reduction after adjustment for baseline MR area, age, and PDA size. Results: PLMVP patients had numerically larger PDA diameters, more severe MR, and greater left-heart enlargement at baseline. All groups showed significant early reverse remodeling and MR reduction (p < 0.001), with the greatest immediate MR-area reduction in PLMVP. From discharge to the latest follow-up, adjusted MR area decreased further in IPTO, remained stable in IPSL, and increased numerically in PLMVP but remained below baseline; the group-by-time interaction was not significant (p = 0.108). After adjustment, intervention strategy was not independently associated with net MR-area reduction (p = 0.874). Conclusions: MR improved after interventions involving PDA closure. In patients without structural mitral abnormalities, isolated closure was associated with reverse remodeling and MR regression. In PLMVP patients, improvement reflected the combined effects of PDA closure, volume-overload relief, and anatomically indicated mitral repair. Concomitant MVP should be individualized according to valve morphology.

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Keywords

Patent ductus arteriosus; mitral valve; interventional treatment; surgical ligation

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