To summarize the influencing factors and clinical outcome of aortic valve regurgitation (AR) in children with patent ductus arteriosus (PDA) after transcatheter closure.

In the retrospective study from January 2016 to June 2019, 8 patients (6 males, 2 females) with new AR after PDA occlusion in Qingdao Women and Children's Hospital were summarized in all 262 cases. The effects of age, weight, body surface area (BSA), diameter of PDA, diameter of occluder, ratio of pulmonary/systemic blood flow (Qp/Qs), the difference value of aorta systolic pressure and pulse pressure pre-operation and post-operation were analyzed in new AR children. The outcome of AR was closely followed up.

Compared with the normal children, there was a significant difference in the difference value of pulse pressure pre-operation and post-operation in new AR children (23.33 ± 8.38 mmHg vs 16.00 ± 6.08 mmHg, P < 0.01). Age, weight, PDA diameter, BSA, Qp/Qs and the difference value of aorta systolic before and after occlusion between thetwo groups did not have significant difference (P > 0.05). All the 8 new AR cases were mild and recovered to normal 3 d to 1 month after occlusion. AR was more severe in 3 children after occlusion than before. Two of them were complicated with bicuspid of aortic valve, and were mild to moderate during 6 months ~ 1 year follow-up. One case was suspected of dilated cardiomyopathy, and AR remained moderate without heart failure aggravation on 6 months after occlusion.

The difference value of pulse pressure after PDA occlusion is the main risk factor for the new AR. It may be related to increased diastolic aortic blood volume after operation. The new AR is mostly functional and temporary changes, with a good prognosis in the short and mid-term. It is necessary to pay moer attention to the effect of aortic valve malformation and left ventricular dysfunction.