Abstract 16481: Feasibility and Safety of Transcatheter Closure of Patent Ductus Arteriosus in Infants Weighing <700 Grams

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Abhishek Chakraborty ◽  
Ranjit Philip ◽  
Rush Waller ◽  
Ronak Naik ◽  
Mimily Harsono ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Human Beings ◽  
Average Birth Weight ◽  
Single Center Study ◽  
Procedural Complications ◽  
Patent Ductus

Introduction: Recently, the Amplatzer Piccolo Occluder (APO) was approved for PDA closure for infants weighing > 700 grams. The feasibility and safety of the procedure for anyone below this weight cut-off has not been previously explored. Hypothesis: Transcatheter closure of patent ductus arteriosus (PDA) in premature infants who weigh < 700 grams at the time of the procedure is safe and feasible. Methods: This is a retrospective, single-center, study to explore the outcomes of transcatheter PDA occlusions performed on infants weighing < 700 grams. Results: A total of 18 patients weighing between 540 and 670 grams (mean = 612.8 grams) were identified to have underwent the procedure between the two centers. The gestational age ranged between 22-26 weeks (median 24 weeks), and the average birth weight was 537.5 grams. The mean age at the time of PDA closure was 20 days (range 8-35 days). The implant success rate was 100%. The devices used included the MVP-5Q (N=8), the 3-2 APO (N=5) and the 4-2 APO (N=5). The procedure time was 26 ± 23 minutes and fluoroscopy time was 3.7 ± 3.1 minutes. One patient, weighing 640 grams required chest compressions for resuscitation following the procedure, but recovered and since then has grown normally to hospital discharge. There were no other procedural complications. At the latest follow-up (median 1-year), there have been four non-survivors, all unrelated to the procedure. Conclusions: It is feasible and likely safe to perform transcatheter closure of patent ductus arteriosus (PDA) in premature infants who weigh < 700 grams using currently available technologies. There is a learning curve with these interventions. Extreme care must be taken while performing interventions in such small human beings. Further miniaturization of equipment would facilitate better outcomes.

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

2017 ◽  
Vol 103 (3) ◽  
pp. F198-F201 ◽  
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.

Transcatheter Closure of Patent Ductus Arteriosus in Under 6 kg and Premature Infants

2015 ◽  
Vol 28 (2) ◽  
pp. 180-189 ◽  
Author(s):  
OSMAN BASPINAR ◽  
DERYA AYDIN SAHIN ◽  
AYSE SULU ◽  
AHMET IRDEM ◽  
GOKHAN GOKASLAN ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Patent Ductus

Long-term Follow-up Results of Lung Perfusion Studies after Transcatheter Closure of Patent Ductus Arteriosus

2012 ◽  
Vol 8 (2) ◽  
pp. 159-166 ◽  
Author(s):  
Fadli Demir ◽  
Ahmet Celebi ◽  
Turkay Saritas ◽  
Abdullah Erdem ◽  
Halil Demir ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Lung Perfusion ◽  
Perfusion Studies ◽  
Long Term Follow Up ◽  
Patent Ductus

scholarly journals Transcatheter closure of patent ductus arteriosus using duct occluder: an eleven-year experience from a single tertiary cardiac center

2019 ◽  
Vol 7 (8) ◽  
pp. 2894
Author(s):  
Achyut Sarkar ◽  
Neha Rani ◽  
Prashant Kumar ◽  
Shyam Sundar Chaudhary ◽  
Suman Chatterjee
Keyword(s):  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Postgraduate Medical Education ◽  
Ductus Arteriosus ◽  
Volume Overload ◽  
Residual Shunt ◽  
Term Outcome ◽  
Procedural Success ◽  
Patent Ductus

Background: Patent Ductus Arteriosus (PDA) is a common congenital disorder. As an isolated lesion, PDA constitutes 6 to 11% of all congenital heart disease. PDA needs closure to eliminate pulmonary over circulation leading to volume overload of left ventricle, pulmonary vascular obstructed disease.Methods: This retrospective study was carried out in pediatric cardiology unit of Institute of Postgraduate Medical Education and Research, Kolkata from September 2005 to August 2016, which included 503 patients.Results: Device closure was attempted in 492 patient’s Procedural success was achieved in 85% cases on table, in who check aortogram revealed complete closure of PDA. In 15% cases, residual shunt was present. In 12% of cases, residual shunt disappeared during follow-up echocardiogram over 6-month follow-up. In 3% cases, small shunt remained at 6-month and 1-year follow up.Conclusion: Transcatheter closure of PDA by duct occluder is safe and effective with good mid-term outcome. The optimum assessment of ductul size and anatomy is crucial for optimum device size, which prevents residual shunt, device embolization and protrusion.

scholarly journals Transcatheter Closure of Patent Ductus Arteriosus in Elderly Patients: Initial and One-Year Follow-Up Results—Do We Have the Proper Device?

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Michal Galeczka ◽  
Malgorzata Szkutnik ◽  
Jacek Bialkowski ◽  
Sebastian Smerdzinski ◽  
Mateusz Knop ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Nyha Class ◽  
Ductus Arteriosus ◽  
Wire Mesh ◽  
Residual Shunt ◽  
One Year ◽  
Patent Ductus

Objectives. Patent ductus arteriosus (PDA) in elderly patients is an uncommon anomaly, and the duct itself is often calcified and fragile; therefore, transcatheter closure is more difficult. The aim is to analyse periprocedural and one-year follow-up results of transcatheter closure of PDA in such patients. Methods and results. Retrospective analysis of 33 elective patients aged ≥55 years (median 63; 56–85; 29 women), in whom PDA was closed percutaneously between 2002 and 2018 in two tertiary centres. All but three patients were symptomatic, with most in NYHA II (n = 14) and III (n = 11) class; pulmonary hypertension (n = 22), arterial hypertension (n = 22), duct calcifications (n = 17), atrial fibrillation (n = 15), significant mitral regurgitation (n = 5), and decompensated renal failure (n = 2) were observed. Different devices were applied depending on PDA morphology; nitinol wire mesh occluders with symmetrical articulating discs have been the most used in recent years (n = 11). Follow-up was conducted at an outpatient clinic (28/33 patients). The procedure was successful in all patients. There was one embolisation, followed by implantation of a larger device. No major complications were noted. A small residual shunt was present in echocardiography in one patient after one year. NYHA class improved in all but two patients (with multiple comorbidities). Conclusions. Transcatheter PDA closure in elderly patients is safe and efficient with a high complete closure rate and few complications. Amplatzer duct occluder type II is an attractive device in such patients.

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