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Méot M, Haddad RN, Patkai J, Abu Zahira I, Di Marzio A, Szezepanski I, Bajolle F, Kermorvant E, Lapillonne A, Bonnet D, Malekzadeh-Milani S. Spontaneous Closure of the Arterial Duct after Transcatheter Closure Attempt in Preterm Infants. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121138. [PMID: 34943334 PMCID: PMC8700662 DOI: 10.3390/children8121138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/13/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Transcatheter closure of the patent arterial duct (TCPDA) in preterm infants is an emerging procedure. Patent arterial duct (PDA) spontaneous closure after failed TCPDA attempts is seen but reasons and outcomes are not reported; (2) Methods: We retrospectively included all premature infants <2 kg with abandoned TCPDA procedures from our institutional database between September 2017 and August 2021. Patients’ data and outcomes were reviewed; (3) Results: The procedure was aborted in 14/130 patients referred for TCPDA. Two patients had spasmed PDA upon arrival in the catheterization laboratory and had no intervention. One patient had ductal spasm after guidewire cross. Four patients had unsuitable PDA size/shape for closure. In seven patients, device closure was not possible without causing obstruction on adjacent vessels. Among the 12 patients with attempted TCPDA, five had surgery on a median of 3 days after TCPDA and seven had a spontaneous PDA closure within a median of 3 days after the procedure. Only the shape of the PDA differed between the surgical ligation group (short and conical) and spontaneous closure group (F-type); (4) Conclusions: In the case of TCPDA failure, mechanically induced spontaneous closure may occur early after the procedure. Surgical ligation should be postponed when clinically tolerated.
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Affiliation(s)
- Mathilde Méot
- Centre de Référence Malformations Cardiaques Congénitales Complexes—M3C, Hôpital Necker-Enfants Malades, 75015 Paris, France; (R.N.H.); (I.A.Z.); (I.S.); (F.B.); (D.B.); (S.M.-M.)
- Correspondence: ; Tel.: +33-144494357
| | - Raymond N. Haddad
- Centre de Référence Malformations Cardiaques Congénitales Complexes—M3C, Hôpital Necker-Enfants Malades, 75015 Paris, France; (R.N.H.); (I.A.Z.); (I.S.); (F.B.); (D.B.); (S.M.-M.)
| | - Juliana Patkai
- Neonatology Department, Port-Royal Hospital, 75014 Paris, France;
| | - Ibrahim Abu Zahira
- Centre de Référence Malformations Cardiaques Congénitales Complexes—M3C, Hôpital Necker-Enfants Malades, 75015 Paris, France; (R.N.H.); (I.A.Z.); (I.S.); (F.B.); (D.B.); (S.M.-M.)
| | - Anna Di Marzio
- Anesthesiology, Hôpital Necker-Enfants Malades, 75015 Paris, France;
| | - Isabelle Szezepanski
- Centre de Référence Malformations Cardiaques Congénitales Complexes—M3C, Hôpital Necker-Enfants Malades, 75015 Paris, France; (R.N.H.); (I.A.Z.); (I.S.); (F.B.); (D.B.); (S.M.-M.)
| | - Fanny Bajolle
- Centre de Référence Malformations Cardiaques Congénitales Complexes—M3C, Hôpital Necker-Enfants Malades, 75015 Paris, France; (R.N.H.); (I.A.Z.); (I.S.); (F.B.); (D.B.); (S.M.-M.)
| | - Elsa Kermorvant
- Neonatology Department, Hôpital Necker-Enfants Malades, 75015 Paris, France; (E.K.); (A.L.)
- UFR de Médecine, Université de Paris, Site Cordeliers, 75006 Paris, France
| | - Alexandre Lapillonne
- Neonatology Department, Hôpital Necker-Enfants Malades, 75015 Paris, France; (E.K.); (A.L.)
- UFR de Médecine, Université de Paris, Site Cordeliers, 75006 Paris, France
| | - Damien Bonnet
- Centre de Référence Malformations Cardiaques Congénitales Complexes—M3C, Hôpital Necker-Enfants Malades, 75015 Paris, France; (R.N.H.); (I.A.Z.); (I.S.); (F.B.); (D.B.); (S.M.-M.)
- UFR de Médecine, Université de Paris, Site Cordeliers, 75006 Paris, France
| | - Sophie Malekzadeh-Milani
- Centre de Référence Malformations Cardiaques Congénitales Complexes—M3C, Hôpital Necker-Enfants Malades, 75015 Paris, France; (R.N.H.); (I.A.Z.); (I.S.); (F.B.); (D.B.); (S.M.-M.)
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Ductal arterial spasm: a nightmare. Cardiol Young 2020; 30:422-423. [PMID: 31983349 DOI: 10.1017/s1047951119003238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Ductal arterial spasm is a very potentially dangerous incidence during percutaneous device closure of patent ductus arteriosus (PDA), which, otherwise, is a very safe catheter intervention. It is essential to notice its occurrence before device sizing and deploying. Without awareness, it can mislead device selection and can result in serious complication. In this report, we shared our nightmare of ductal spasm during transcatheter closure of PDA in two children which had led to death in one patient.
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Villa E, Folliguet T, Magnano D, Vanden Eynden F, Le Bret E, Laborde F. Video-assisted thoracoscopic clipping of patent ductus arteriosus: close to the gold standard and minimally invasive competitor of percutaneous techniques. J Cardiovasc Med (Hagerstown) 2006; 7:210-5. [PMID: 16645388 DOI: 10.2459/01.jcm.0000215275.55144.17] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To review our 12-year experience in video-assisted thoracoscopic surgery (VATS) for patent ductus arteriosus. METHODS VATS was performed in 743 patients. Three groups were compared: 24 low-birth-weight infants (LBWIs), 676 children between 2.5-25 kg and 43 boys > 25 kg. A diameter of > 8 mm was the main contraindication. For 85 consecutive patients, hospital stay underwent cost analysis. RESULTS Median age was 1.6 years (range 5 days-33 years) and median weight 9.0 kg (range 1.2-65 kg). Mortality was nil. Median operative time was 20 min and hospital stay 2 days. Residual patency at discharge was 0% in LBWIs, 0.7% in children, and 4.7% in boys (P = NS) and 0, 0.3, and 4.7% at follow-up (P = 0.001). Persistent recurrent laryngeal nerve dysfunction was recorded in 4.2% of LBWIs, 0.3% of children and 0% of boys (P = 0.012). Total mean cost was Euro 5954 +/- 2110. CONCLUSIONS The success rate of VATS clipping compares favorably with the thoracotomic approach but without chest wall trauma and it may have a very favorable cost-effective therapeutic balance compared to transcatheter techniques.
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Affiliation(s)
- Emmanuel Villa
- Cardiac Pathology Department, Institut Mutualiste Montsouris, Paris, France.
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