scholarly journals Safety and Outcomes of Transcatheter Closure of Patent Ductus Arteriosus in Children With Pulmonary Artery Hypertension

2020 ◽  
Vol 47 (4) ◽  
pp. 250-257
Author(s):  
Arash Salavitabar ◽  
Usha S. Krishnan ◽  
Mariel E. Turner ◽  
Julie A. Vincent ◽  
Alejandro J. Torres ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Resistance Index ◽  
Pulmonary Artery Hypertension ◽  
Adverse Outcomes ◽  
Closure Device ◽  
Vasodilator Therapy ◽  
Pulmonary Vasodilator ◽  
Patent Ductus

To investigate whether transcatheter device closure of patent ductus arteriosus (PDA) is safe in children with pulmonary artery hypertension, we retrospectively analyzed our experience with 33 patients who underwent the procedure from January 2000 through August 2015. Pulmonary artery hypertension was defined as a pulmonary vascular resistance index (PVRI) >3 WU · m2. All 33 children (median age, 14.5 mo; median weight, 8.1 kg) underwent successful closure device implantation and were followed up for a median of 17.2 months (interquartile range [IQR], 1.0–63.4 mo). During catheterization, the median PVRI was 4.1 WU · m2 (IQR, 3.6–5.3 WU · m2), and the median mean pulmonary artery pressure was 38.0 mmHg (IQR, 25.5–46.0 mmHg). Premature birth was associated with pulmonary vasodilator therapy at time of PDA closure ( P=0.001) but not with baseline PVRI (P=0.986). Three patients (9.1%) had device-related complications (one immediate embolization and 2 malpositions). Two of these complications involved embolization coils. Baseline pulmonary vasodilator therapy before closure was significantly associated with intensive care unit admission after closure (10/12 [83.3%] with baseline therapy vs 3/21 [14.3%] without; P <0.001). Of 11 patients receiving pulmonary vasodilators before closure and having a device in place long-term, 8 (72.7%) were weaned after closure (median, 24.0 mo [IQR, 11.0–25.0 mo]). We conclude that transcatheter PDA closure can be performed safely in many children with pulmonary artery hypertension and improve symptoms, particularly in patients born prematurely. Risk factors for adverse outcomes are multifactorial, including coil use and disease severity. Multicenter studies in larger patient populations are warranted.

Percutaneous Device Closure of Patent Ductus Arteriosus with Pulmonary Artery Hypertension: Long-Term Results

2014 ◽  
Vol 27 (6) ◽  
pp. 563-569 ◽  
Author(s):  
ISHWARAPPA BALEKUNDRI VIJAYALAKSHMI ◽  
NATRAJ SETTY ◽  
CHITRA NARASIMHAN ◽  
VIVEK SINGLA ◽  
CHOLENAHALLI NANJAPPA MANJUNATH
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Pulmonary Artery Hypertension ◽  
Long Term Results ◽  
Device Closure ◽  
Percutaneous Device ◽  
Percutaneous Device Closure ◽  
Patent Ductus

Non-operating room anaesthesia for embolisation of ductus closure device to the pulmonary artery in a child with patent ductus arteriosus

2019 ◽  
Vol 29 (5) ◽  
pp. 725-726 ◽  
Author(s):  
Yeliz Kılıç ◽  
Mehmet Ali Harbelioğlu
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Operating Room ◽  
Heart Diseases ◽  
Rare Complication ◽  
Anesthetic Management ◽  
Ductus Arteriosus ◽  
Closure Device ◽  
First Case ◽  
Patent Ductus

ABSTRACTPatent ductus arteriosus is among the most common congenital heart diseases. With the increasing use of transcatheter closure procedures, the incidence of complications related to the procedure has increased. Embolization of the ductus closure device to the pulmonary artery is a very rare complication. Since those procedures are often performed under non-operating room anesthesia, anesthetic management of such patients is of great importance. Herein, anesthetic management of embolization of the ductus closure device to the pulmonary artery in a little girl was presented. This is the first case regarding the anesthetic management of such complication.

Operable patent ductus arteriosus even with differential cyanosis: a case of patent ductus arteriosus and mitral stenosis

2017 ◽  
Vol 27 (9) ◽  
pp. 1845-1848 ◽  
Author(s):  
Anunay Gupta ◽  
Shyam S. Kothari
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Mitral Stenosis ◽  
Ductus Arteriosus ◽  
Pulmonary Artery Hypertension ◽  
Early Age ◽  
Eisenmenger Syndrome ◽  
Corrective Surgery ◽  
Patent Ductus

AbstractPatients with patent ductus arteriosus and significant left-to-right shunt develop Eisenmenger syndrome at an early age and are not operable after development of irreversible pulmonary artery hypertension. Patients with mitral stenosis, however, are treatable even with suprasystemic pulmonary artery pressures. A combination of these two lesions is rare. We document a patient with differential cyanosis who improved after corrective surgery of both the lesions. The importance of post-capillary pulmonary artery hypertension in shunt lesions needs to be better appreciated.

scholarly journals Hospital Outcomes of Surgical Closure of Patent Ductus Arteriosus: 19 Years Experience at Shahid Gangalal National Heart Center

2020 ◽  
Vol 18 (2) ◽  
pp. 30-35
Author(s):  
R. Koirala ◽  
N. Panthee ◽  
S. Pradhan ◽  
N. Rajbhandari ◽  
D.K. Shrestha ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Pulmonary Artery Hypertension ◽  
Hospital Outcomes ◽  
Descending Aorta ◽  
Surgical Closure ◽  
First Case ◽  
Patent Ductus

Background Ductus arteriosus is a vascular structure which connects the roof of main pulmonary artery near the origin of the left branch pulmonary artery to the proximal descending aorta. Patent ductus arteriosus (PDA) closure is indicated for any patient who is symptomatic from left to right shunting. Objective To investigate the hospital outcomes of surgical closure of patent ductus arteriosus over last 19 years starting from the very first case of our center. Method This is a retrospective analysis of all patent ductus arteriosus treated surgically from August 2001 to July 2019. Patients who underwent isolated surgical closure of patent ductus arteriosus were included. Data have been presented in three different eras (Era 1: 2001-2007, Era 2: 2008-2013, and Era 3: 2014-2019) to see the trend of evolution of this surgery. Result A total of 901 patients aged 8.67±8.76 years under went patent ductus arteriosus surgical closure over last 19 years. Patients in the initial era 2001-2007 were significantly older compared with other 2 eras (p=0.000). Males accounted for 35.5% of all cases. Twenty percent had severe pulmonary artery hypertension. Duration of mechanical ventilation was 3.57±9.64 hours with ICU stay of 1.55±1.53 days, and hospital stay of 3.9±2.3 days. Overall in hospital mortality was 0.8%; for isolated patent ductus arteriosus diagnosis, mortality was 0.2%. Chylothorax was noted in 0.4%. Conclusion This is the first report to analyze surgical outcomes of patent ductus arteriosus ligation in our center. We have discussed the evolution of patent ductus arteriosus surgery in our center, and have shown favorable outcomes in terms of morbidity and mortality.

Abstract 13501: Patent Ductus Arteriosus Catheterization Closure in Preterm Infants: A Descriptive Study of an Institutional Experience

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Heidi Kim ◽  
Sushmita Yallapragada ◽  
Rashmin C Savani ◽  
Vedanta Dariya ◽  
Sana Ullah ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Gestational Age ◽  
Ductus Arteriosus ◽  
Retrospective Chart Review ◽  
Pulmonary Artery Hypertension ◽  
Adverse Outcomes ◽  
Critical Congenital Heart Disease ◽  
Oxygen Requirements ◽  
Patent Ductus

Introduction: A patent ductus arteriosus (PDA) in a preterm infant can lead to respiratory insufficiency and chronic lung disease as well as necrotizing enterocolitis due to systemic hypoperfusion. Recently, catheter-based PDA closure has emerged as an appealing alternative to invasive surgical ligation in preterm infants; however, evidence to support this procedure in infancy, particularly in the premature population, is still evolving. Methods: A retrospective chart review was conducted to collect information regarding demographics, neonatal and maternal clinical characteristics, and procedural and post-catheterization data. Inclusion criteria included infants born at <32 weeks gestational age whose PDAs were closed via catheterization at our institution between January 2017 and August 2019. Infants with critical congenital heart disease and/or lethal congenital anomalies were excluded from this study. Results: Twenty-seven patients were included in our study. Indications for PDA closure in our patient population included hemodynamically significant PDA on echocardiogram, difficulty weaning respiratory support, poor feeding and weight gain, and development of NEC. Median gestational age and weight were 26 weeks and 820 g (ranging from 23 to 30 weeks and 400 to 1540 g, respectively). Most infants tolerated the procedure well and without serious adverse outcomes. One infant developed an intimal flap post-catheterization that resolved without invasive intervention, and 1 infant developed a PAH crisis after PDA closure with resolution of PAH prior to discharge. Statistically significant associations were found between PDA plug closures and decreased oxygen requirements, decreased pulmonary artery hypertension, decreased diuretic requirements, and decreased vasodilator requirements by time of discharge. Conclusions: Successful device closures of PDAs are feasible and safe, and preliminary findings show promising outcomes without mortality or long-term morbidity following transcatheter PDA closure.

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