الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: PDA closure leads to acute hemodynamic changes .It was demonstrated that these hemodynamic changes after PDA closure were based on echocardiography, However performing an echocardiogram could be technically challenging. The aim of the work: Aim of this thesis is to record acute hemodynamic changes caused by the abrupt closure of ductus arteriosus shunting in infants , children, adolescent and to evaluate the factors which may affect these hemodynamic changes. Type of study: Present study is a prospective cohort study. Materials and Methods: The present study was conducted on a group of 30 patients with diagnosis of isolated PDA aged from 8 months up to 11 years and prepared for trans catheter device closure. The patients were enrolled consecutively from cardiology unit at Mansoura University Children`s Hospital (MUCH ). where a non invasive COP monitoring device ” electrical cardiometry ICON ”Osypka was applied 1 h before and 1h, 6 h, 12h, 24 h after the transcatheter closure. Data included heart rate (HR), stroke volume (SV), cardiac output (CO ), cardiac index (CI), contractility indices, systemic vascular resistance (SVR) were collected at these intervals. Results: The current observation showed a statistically significant decline in SV, SI, CO,CI at 1 h compared to 6 h with p-value >0.001and more decline at 12 h compared to 24 h post catheter with same significant p-value >0.001. Follow up of contractility indices of myocardial function showed delayed significant decline in ICON, CPI, STR (PEP /LVET ) after ductal closure at 6 h with p-value >0.001 and subsequent significant decline at 12 h, 24 h postcatheter with the same significant P-value which indicating ventricular systolic Dissertation Abstract Central library dysfunction. SVR, SVRI follow up after transcatheter closure in the current study shows significant raise at 1 h, 6 h, 12 h and 24 h after closure with P-value>0.049 and >0.001 respectively. Conclusion: Trans catheter occlusion of PDA is associated with significant acute reduction in LV output, this is due to the decrease in SV simultaneously with myocardial dysfunction associated with the increase in afterload post catheter, all of them affecting the end result of cardiac output. Recommendations: Further monitoring of cardiac hemodynamics should be done at subsequent remote interval after transcatheter PDA closure to asses further follow up changes.