Stent angioplasty to relieve left pulmonary artery obstruction caused by patent ductus arteriosus device occlusion

AbstractDuctus arteriosus is an essential component of fetal circulation. Due to occurring changes in the cardiopulmonary system physiology after birth, ductus arteriosus closes. Patent ductus arteriosus can be closed by medical or invasive (percutaneous or surgical) treatment methods. Percutaneous or surgical closure of patent ductus arteriosus can be performed for the cases that medical closure failed. Surgical treatment is often preferred method for closure of patent ductus arteriosus in the neonatal period. The most common surgical complications are pneumothorax, recurrent laryngeal nerve injury, bleeding, and recanalisation. A very rare surgical complication is left pulmonary artery ligation that has been presented in a few cases in the literature. Echocardiography control should be performed in the early post-operative period, especially in patients with clinical suspicion. If reoperation is required, it should never be delayed. We report a newborn patient whose left pulmonary artery ligated accidentally during patent ductus arteriosus closure surgery and surgical correction of this complication at the early post-operative period.

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Inadvertent Ligation of the Left Pulmonary Artery Instead of Patent Ductus Arteriosus Noninvasive Diagnosis by Pulmonary Perfusion Imaging

Clinical Nuclear Medicine ◽

10.1097/00003072-198609000-00007 ◽

1986 ◽

Vol 11 (9) ◽

pp. 629-630 ◽

Cited By ~ 5

Author(s):

JOSEPH A. ORZEL ◽

MICHELE P. MONACO

Keyword(s):

Pulmonary Artery ◽

Patent Ductus Arteriosus ◽

Perfusion Imaging ◽

Ductus Arteriosus ◽

Left Pulmonary Artery ◽

Noninvasive Diagnosis ◽

Pulmonary Perfusion ◽

Patent Ductus

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Transcatheter occlusion of the patent ductus arteriosus in premature infants weighing less than 1200 g

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2016-312582 ◽

2017 ◽

Vol 103 (3) ◽

pp. F198-F201 ◽

Cited By ~ 18

Author(s):

Patrice Morville ◽

Stephanie Douchin ◽

Helene Bouvaist ◽

Claire Dauphin

Keyword(s):

Patent Ductus Arteriosus ◽

Premature Infants ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Left Pulmonary Artery ◽

Transcatheter Occlusion ◽

Alternative Means ◽

The Mean ◽

Pulmonary Artery Obstruction ◽

Patent Ductus

ObjectivesOver the last few decades different strategies have been proposed to treat persistent ductal patency in premature infants. The advent of the Amplatzer Duct Occluder II Additional Size (ADOIIAS) provided the potential to close the patent ductus arteriosus (PDA). Opinions differ on the significance and treatment of PDA in premature neonates. Because surgical ligation and medical therapy both have their drawbacks, interventional catheterisation can be considered as an alternative means of closing the ductus arteriosus. Our aim was to analyse the feasibility, safety and efficacy of this device in premature infants weighing <1200 g at procedure.MethodsEighteen premature infants underwent transcatheter closure. The procedure was performed in the catheterisation laboratory by venous cannulation without angiography. The position of the occluder was directed by X-ray and ultrasound. We looked at procedural details, device size selection, complications and short-term and mid-term outcomes.ResultsEighteen infants born at gestational ages ranging between 23.6 and 29+6 weeks (mean±SD 25+6±3 weeks) underwent transcatheter PDA closure. Their mean age and weight at the time of the procedure was 20 days (range 8–44 days) and 980 g (range 680–1200 g), respectively. The mean PDA and device waist diameters were 3.2±0.6 mm (range 2.2–4 mm) and 4.5±0.6 mm, respectively, and the mean PDA and device lengths were 4.3±1.2 mm (range 2–10 mm) and 2.5±0.9 mm, respectively. Complete closure was achieved in all but one patient. There was no device migration. One patient developed a left pulmonary artery obstruction. Three infants died. Two deaths were related to complications of prematurity and one to the procedure.ConclusionsTranscatheter closure of a PDA is feasible in very low weight infants with ADOIIAS and is an alternative to surgery. Success requires perfect selection and placement of the occluder.

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