Transcatheter device closure of patent ductus arteriosus by exclusive venous access under echocardiographic guidance without angiography

2021 ◽  
pp. 1-5
Author(s):  
Salem Deraz ◽  
Mohamed Tawfik ◽  
Susy Kotit ◽  
Abdelrahman Elafifi
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Vascular Complications ◽  
Venous Access ◽  
Device Closure ◽  
Arterial Access ◽  
Surgical Closure ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

Abstract Introduction: The standard transcatheter technique to profile the patent ductus arteriosus requires arterial access through the femoral artery and is associated with arterial complications, longer fluoroscopic time, contrast volume, and longer hospital stay. Aim of the study: To compare exclusive transvenous access with the standard procedures for patent ductus arteriosus closure and evaluate whether exclusive venous approach is a safe and effective alternative. Methods: A total of 320 patients were included. A detailed echocardiographic evaluation of the duct morphology was performed. Patients were classified into group 1 included patients who underwent exclusive femoral venous access, without any injections of contrast media and group 2 included patients who underwent arterial and venous access. Results: Arterial access was achieved in 210 (65.6%). Successful closure of patent ductus arteriosus was achieved in 109 (99.1%) patients in group 1 and in 203 (96.7%) patients in group 2. The patent ductus arteriosus was large and was referred for surgical closure in one patient from group 1 and 7 patients from group 2. Residual patent ductus arteriosus was seen in 6 cases from group 1 (5.4%) and 12 patients from group 2 (5.7%). None of the cases in group 1 had vascular complications, while vascular complications were seen in 20 cases, all of them in group 2 (9.5%). Nonvascular complications were seen in one patient from group 1 (0.9%) and 15 patients in group 2 (7.1%). The procedure time and fluoroscopy times were less in patients with exclusive transvenous access. Conclusion: Patent ductus arteriosus device closure without arterial access can be accomplished safely and effectively.

Surgical Closure of Patent Ductus Arteriosus in Infants Weighing Less than 2.5kg

1995 ◽  
Vol 3 (1) ◽  
pp. 13-15
Author(s):  
Somboon Boonkasem ◽  
Boonchob Pongpanich ◽  
Anant Tejavei
Keyword(s):  
Heart Failure ◽  
Birth Weight ◽  
Renal Insufficiency ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Low Birth Weight Infants ◽  
Surgical Closure ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

Persistent heart failure is a major problem in low birth weight infants with patent ductus arteriosus (PDA). There is a considerable incidence of renal insufficiency and reopening of the ductus after pharmacologic closure. Surgical closure of symptomatic PDA should therefore be indicated to avoid morbidity or mortality from heart failure and renal failure. Between March 1990 and December 1993 there were 33 low birth weight infants who underwent surgical closure of PDA, ranging in age from 5 to 90 days (mean = 25) with 15 males and 18 females (M:F = 1:1.2). The patients were classified into 3 groups: group 1 (< 1000gm) 11 cases, group 2 (1000-1499gm) 10 cases, group 3 (1500-2499gm) 12 cases. The indications for surgical closure of PDA included: persistent heart failure in 28, renal insufficiency in 20, reopening of the ductus after pharmacologic closure in 16 and growth failure in 1. The early mortality was 6% (2/33). Both of them were in group 1: one from necrotizing enterocolitis (NEC), and one from cytomegalovirus (CMV) infection on the 6th and 20th postoperative day respectively. Late death occurred twice: the first case in group 1 from sepsis 35 days postoperatively, and the second in group 2 from pneumonia 3 months after surgery. The causes of late mortality in both cases were not related to surgery. The 29 survivors are doing reasonably well during follow-up period.

A beneficial technique for preventing the device protrusion to the aorta during percutaneous patent ductus arteriosus closure: “Balloon-assisted device releasing technique”

2019 ◽  
Vol 29 (11) ◽  
pp. 1380-1386 ◽  
Author(s):  
Serdar Epçaçan ◽  
Mustafa Orhan Bulut ◽  
İlker Kemal Yücel ◽  
Ahmet Çelebi
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Safe Procedure ◽  
Disc Protrusion ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Patent Ductus Arteriosus Closure ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

AbstractBackground:Although percutaneous closure of patent ductus arteriosus is an established safe procedure, protrusion of the device to descending aorta may occur in various degrees during these procedures, especially in small infants. The aim of our study is to evaluate the benefits of balloon-assisted device releasing technique in the era of preventing device protrusion and conditions related to protrusion.Methods:One hundred and fifty-five infants, who underwent patent ductus arteriosus closure with Amplatzer duct occluder I device between January, 2012 and December, 2018, were retrospectively analysed. Balloon-assisted device releasing technique was used in 20 cases (group 1, 12.9%), between January, 2015 and December, 2018. Procedures in which the technique had been used were compared with the remaining ones (group 2, 87.1%, n = 135) with regard to device stabilisation, aortic disc protrusion to the aorta, iatrogenic coarctation, and device embolisation.Results:There was no significant difference by means of gender, age, weight, and the ductal diameter, whereas the average mean pulmonary artery pressure was significantly higher in group 1. Device protrusion and related complications were significantly higher in group 2; thus, additional catheterisations or surgical interventions were required, while no additional intervention was required in group 1.Conclusion:The balloon-assisted device releasing technique provides a good device stabilisation and prevents protrusion of the device and related complications during percutaneous patent ductus arteriosus closure in selected cases.

Outcomes among preterm infants with patent ductus arteriosus: Relationship with treatment, gestational age, hemodynamic status and timing of treatment

2021 ◽  
pp. 1-9
Author(s):  
S.M. Chikkabyrappa ◽  
N. Chaudhary ◽  
A. Agarwal ◽  
D. Rastogi ◽  
P. Filipov ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Retrospective Case ◽  
Chi Square ◽  
Hemodynamic Status ◽  
Group 3 ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

BACKGROUND: There remains controversy regarding the outcomes resulting from treatment versus conservative management of patent ductus arteriosus (PDA) among preterm infants. The effects of extreme prematurity, hemodynamic status of the PDA, and age at treatment remain poorly defined. STUDY DESIGN: This retrospective case-control study including infants <  1250 gm who were categorized into 3 groups: Group 1: without PDA, Group 2: with untreated PDA, and Group 3: treated PDA. Diagnosis and treatment of PDA extracted from the medical records. Demographics, clinical characteristics, and outcomes compared using chi-square and analysis of variance. Logistic regression used to estimate adjusted odds ratios. RESULTS: The study included 734 infants, with 141(19%) in Group 1, 329 (45%) in 2, and 264 (36%) in 3. Group 3 had higher incidence of bronchopulmonary dysplasia (BPD) (aOR, 2.9; 95%CI 1.7–4.8). Infant treated for hemodynamically significant PDA (HSPDA) had higher incidence of BPD (aOR, 1.9; 95%CI 1.0–3.8) and retinopathy of prematurity (ROP) (aOR, 3.4; 95%CI 1.6–6.9). There were no differences in outcome associated with treatment among≤26 weeks gestation and the age when treated. CONCLUSION: Infants with PDA who were treated had higher incidence of BPD. Among those who were treated, those with HSPDA had a higher incidence of BPD and ROP.

scholarly journals Transcatheter device closure of patent ductus arteriosus without arterial access – Single institution experience

2013 ◽  
Vol 65 (5) ◽  
pp. 546-551 ◽  
Author(s):  
Gaurav Garg ◽  
Anurakti Srivastava ◽  
Himanshu Tyagi ◽  
Sridhar P. Reddy ◽  
Anil Sivadasan Radha
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Device Closure ◽  
Single Institution ◽  
Arterial Access ◽  
Transcatheter Device ◽  
Patent Ductus

scholarly journals Comparison of isolated venous approach with the standard approach in children undergoing patent ductus arteriosus device closure

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Lipi Uppal ◽  
Manoj Kumar Rohit ◽  
Parag Barwad ◽  
Sanjeev Naganur ◽  
Uma Debi ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Vascular Complications ◽  
Standard Approach ◽  
Safe Procedure ◽  
Device Closure ◽  
Young Infants ◽  
Group I ◽  
Group Ii ◽  
Patent Ductus

Abstract Background Transcatheter device closure is a safe procedure recommended in children with patent ductus arteriosus (PDA). While the standard procedure uses arterial and venous femoral access, it poses risk of vascular complications especially in young infants. Isolated venous approach has been tried in a few studies and was found to be non-inferior to the standard technique. In this prospective observational study, we have compared the two vascular approaches of PDA device closure in pediatric patients and have also studied the feasibility of this approach in young children with weight < 6 kg. Results PDA device occlusion was performed with either one of the approaches—venous alone (group I) or standard approach (group II) in a total of 135 children enrolled prospectively. The baseline data, procedural outcomes, vascular complications, and radiation dose were compared between the two groups. Fifty-two and 83 children were included in group I and group II, respectively. A total of 22 children (16%) (13 in group I; 9 in group II) had weight < 6 kg. In group II, 6 children (7.2%) had vascular site complications treated with heparin infusion with two children requiring thrombolysis. Another child in group II developed intravascular hemolysis following residual shunt, requiring surgical device retrieval and closure. No significant differences were observed in mean fluoroscopic time (p = 0.472) and air kerma between the two groups (p = 0.989). Conclusion Transcatheter PDA device closure without arterial access is a feasible and safe option in children including young infants. This technique avoids the risk of vascular complications although requires careful case selection.

Ligation of left pulmonary artery instead of patent ductus arteriosus

2020 ◽  
Vol 30 (12) ◽  
pp. 1943-1945
Author(s):  
Semih Murat Yucel ◽  
Irfan Oguz Sahin
Keyword(s):  
Surgical Treatment ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Surgical Complication ◽  
Ductus Arteriosus ◽  
Left Pulmonary Artery ◽  
Artery Ligation ◽  
Surgical Closure ◽  
Post Operative Period ◽  
Patent Ductus

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.

scholarly journals SURGICAL CLOSURE OF ATYPICAL PATENT DUCTUS ARTERIOSUS

1956 ◽  
Vol 31 (3) ◽  
pp. 332-337
Author(s):  
N.A. Antonius ◽  
L.G. Massarelli ◽  
A.D. Crecca
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Surgical Closure ◽  
Patent Ductus

Intravascular ultrasonography-guided measurement and transcatheter closure of highly calcified patent ductus arteriosus in an older adult

2021 ◽  
pp. 1-3
Author(s):  
Yoko Kawai ◽  
Takeshi Nakamura ◽  
Satoaki Matoba
Keyword(s):  
Older Adults ◽  
Patent Ductus Arteriosus ◽  
Older Adult ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Ct Images ◽  
Device Closure ◽  
Intravascular Ultrasonography ◽  
Patent Ductus

Abstract In older adults with patent ductus arteriosus, CT is widely used for duct visualisation because angiography images can be inadequate for evaluation. We report the case of a 73-year-old woman with a highly calcified patent ductus arteriosus whose CT images were insufficient for accurate measurement. Intravascular ultrasonography is useful for sizing of and guiding device closure of the duct.

scholarly journals Low-Dose Intravenous Paracetamol for Patent Ductus Arteriosus in Indomethacin-Resistant or Contraindicated Preterm Infants: Three Cases Reports

2017 ◽  
Vol 07 (04) ◽  
pp. e230-e233 ◽  
Author(s):  
Shun Matsumura ◽  
Ayumi Oshima ◽  
Sumie Fujinuma ◽  
Kosuke Tanaka ◽  
Nobuhiko Nagano ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Limited Data ◽  
Gastrointestinal Complications ◽  
Surgical Closure ◽  
Institutional Ethics ◽  
Intravenous Paracetamol ◽  
Administration Protocol ◽  
Patent Ductus

Background Although indomethacin (IND) is the standard treatment for hemodynamically significant patent ductus arteriosus (hsPDA) in Japan, it may be associated with renal impairment and gastrointestinal complications. The use of paracetamol for hsPDA closure has recently increased. Unlike IND, paracetamol does not have a peripheral vasoconstrictive effect and can be given to infants with contraindications to IND. Based on limited data available from randomized trials, paracetamol and IND seem to have similar effects. However, there have been no reports of the use of paracetamol for hsPDA in Japan. Cases Our drug administration protocol was approved by the institutional ethics committee after purchasing a clinical trial insurance. In three premature infants in whom IND was contraindicated or ineffective, a 7.5 mg/kg of paracetamol was intravenously administered every 6 hour for 3 days after obtaining parental consents. A temporary hsPDA closure was observed in two of the three infants. However, all three infants eventually needed surgical closure. No side effects, such as hepatic and renal dysfunctions, and adverse events were reported. Conclusion The intravenous administration of paracetamol was safe and feasible in premature infants with hsPDA. Future clinical trials with optimized dose and timing of administration are needed.

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