TY  - EJOU
AU  - Tang, Jiaqing 
AU  - Fang, Yushen 
AU  - Li, Jiahong 
AU  - Li, Zechen 
AU  - Yang, Zhuyang 
AU  - Xie, Huiru 
AU  - Tian, Miao 
AU  - Su, Zhanhao 
AU  - Wen, Shusheng 
AU  - Li, Xiaohua 
AU  - Yuan, Haiyun 

TI  - Isolated Closure versus Mitral Valvuloplasty for Patent Ductus Arteriosus in Patients with Mitral Regurgitation: A Single-Center, Retrospective Study
T2  - Structural and Congenital Heart Disease

PY  - 
VL  - 
IS  - 
SN  - 3071-1738

AB  - <b>Background:</b> 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). <b>Methods:</b> 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. <b>Results:</b> 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 (<i>p</i> &lt; 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 (<i>p</i> = 0.108). After adjustment, intervention strategy was not independently associated with net MR-area reduction (<i>p</i> = 0.874). <b>Conclusions:</b> 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.
KW  - Patent ductus arteriosus; mitral valve; interventional treatment; surgical ligation

DO  - 10.32604/schd.2026.080591