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Fernandez MC, Kase JS, Giamelli J, Reichlin A. Morbidity and neurodevelopmental outcomes at 2 years in preterm infants undergoing percutaneous transcatheter closure vs. surgical ligation of the PDA. J Perinatol 2024:10.1038/s41372-024-02019-w. [PMID: 38831120 DOI: 10.1038/s41372-024-02019-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE Review a cohort of preterm infants ≤29 weeks of gestation at birth and compare morbidities and neurodevelopmental outcomes based on PDA status and type of PDA closure. STUDY DESIGN Single center observational retrospective-prospective case control study of premature infants who had no hsPDA, underwent surgical ligation or percutaneous transcatheter closure of the PDA. Neurodevelopmental testing was done using the Bayley Scales of Infant Development 3rd ed. RESULTS The percutaneous transcatheter closure group had an older post menstrual age and greater weight at the time of procedure, and started enteral feeds and achieved room air status at an earlier post procedure day. Infants in the surgical ligation group were more likely to experience vocal cord paralysis. There was no difference in neurodevelopmental outcomes between groups. CONCLUSION Waiting for infants to achieve the appropriate size for percutaneous transcatheter closure of the PDA may lead to reduced short-term complications without increasing the risk of neurodevelopmental impairment.
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Affiliation(s)
- Maria Cristina Fernandez
- Sunrise Children's Hospital, Las Vegas, NV, USA.
- The Regional Neonatal ICU Maria Fareri Children's Hospital at Westchester Medical Center - New York Medical College Valhalla, Valhalla, NY, USA.
| | - Jordan S Kase
- The Regional Neonatal ICU Maria Fareri Children's Hospital at Westchester Medical Center - New York Medical College Valhalla, Valhalla, NY, USA
| | - Joseph Giamelli
- Pediatric Cardiology Intervention, Maria Fareri Children's Hospital at Westchester Medical Center-New York Medical College Valhalla, Valhalla, NY, USA
| | - Amy Reichlin
- The Regional Neonatal ICU Maria Fareri Children's Hospital at Westchester Medical Center - New York Medical College Valhalla, Valhalla, NY, USA
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SUNKAK S, ARGUN M. Three years of interventional pediatric cardiology experience in a newly built city hospital. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1124163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The importance of interventional methods in the treatment of congenital heart disease (CHD) is increasing. In this article, we retrospectively evaluated our angiography experience for the diagnosis and treatment of congenital heart diseases in the newly built Kayseri City Hospital for 3 years.
Material and Method: The demographic data of the patients, their diagnoses and information about interventions were evaluated retrospectively.
Results: In our center, 291 interventional procedures were performed in a 36-month period. 71 (24%) procedures were for diagnostic evaluation and 220 (76%) procedures were for treatment. 74 (25%) atrial septal defect (ASD) closure procedures, 9 (3%) ventricular septal defect (VSD) closure procedures and 62 (21.3%) patent ductus arteriosus (PDA) closure procedures were performed via percutaneous technique. Eleven of the patients who underwent PDA closure were
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Affiliation(s)
- Süleyman SUNKAK
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KAYSERİ ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ
| | - Mustafa ARGUN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KAYSERİ TIP FAKÜLTESİ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANA BİLİM DALI, ÇOCUK KARDİYOLOJİSİ
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Guyon P, Duster N, Katheria A, Heyden C, Griffin D, Steinbergs R, Moreno Rojas A, Ratnayaka K, El-Said HG. Institutional Trend in Device Selection for Transcatheter PDA Closure in Premature Infants. Pediatr Cardiol 2022; 43:1716-1722. [PMID: 35430709 PMCID: PMC9587941 DOI: 10.1007/s00246-022-02903-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Abstract
We report our experience with transcatheter patent ductus arteriosus (PDA) closure in premature infants and compare patients grouped by the device used for closure: the Microvascular Plug, "MVP" (Medtronic, Minneapolis, MN); Micro Plug Set, "Micro Plug" (KA Medical, Minneapolis, MN); and Amplatzer Piccolo Occluder, "Piccolo" (Abbot, Santa Clara, CA). We also report trends in device selection over time. Studies examining outcomes according to device selection for PDA closure in premature infants are lacking. We performed a retrospective review of all percutaneous PDA closures in premature infants at a single center (June 2018-May 2021). Patients were grouped by initial device selected for PDA closure (intention to treat). Institutional Review Board approval was obtained. 58 premature infants [MVP (n = 25), Micro Plug (n = 25), and Piccolo (n = 8)] underwent successful transcatheter PDA closure (mean gestational age 27 weeks 2 days; mean weight at procedure 1.4 kg; mean age at procedure 28 days). Pre-procedural demographics, procedural data, and follow-up data were similar between groups. There were no significant procedural adverse events. Three devices (2 MVP, 0 Micro Plug, 1 Piccolo p = 0.27) embolized after the procedure. One other device was removed for concern for aortic obstruction. Device selection evolved with a clear trend toward the Micro Plug device over time. Demographic, procedural, and follow-up data were similar between the MVP, Micro Plug, and Piccolo groups. The Micro Plug did not require exchange for suboptimal fitting or embolize and became our preferred device in most cases.
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Affiliation(s)
- Peter Guyon
- Division of Pediatric Cardiology, Rady Children's Hospital | UC San Diego School of Medicine, 3020 Children's Way MC #5004, San Diego, CA, 92123, USA.
| | - Nicole Duster
- Department of Pediatrics, Rady Children's Hospital | UC San Diego School of Medicine, San Diego, CA, USA
| | - Anup Katheria
- Department of Neonatology, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - Caitlyn Heyden
- Division of Pediatric Cardiology, Rady Children's Hospital | UC San Diego School of Medicine, 3020 Children's Way MC #5004, San Diego, CA, 92123, USA
| | - Danica Griffin
- Division of Pediatric Cardiology, Rady Children's Hospital | UC San Diego School of Medicine, 3020 Children's Way MC #5004, San Diego, CA, 92123, USA
| | - Ronald Steinbergs
- Division of Pediatric Cardiology, Rady Children's Hospital | UC San Diego School of Medicine, 3020 Children's Way MC #5004, San Diego, CA, 92123, USA
| | - Andres Moreno Rojas
- Division of Pediatric Cardiology, Rady Children's Hospital | UC San Diego School of Medicine, 3020 Children's Way MC #5004, San Diego, CA, 92123, USA
| | - Kanishka Ratnayaka
- Division of Pediatric Cardiology, Rady Children's Hospital | UC San Diego School of Medicine, 3020 Children's Way MC #5004, San Diego, CA, 92123, USA
| | - Howaida G El-Said
- Division of Pediatric Cardiology, Rady Children's Hospital | UC San Diego School of Medicine, 3020 Children's Way MC #5004, San Diego, CA, 92123, USA
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Lee SJ, Yoo SM, Son MJ, White CS. The Patent Ductus Arteriosus in Adults with Special Focus on Role of CT. Diagnostics (Basel) 2021; 11:diagnostics11122394. [PMID: 34943630 PMCID: PMC8699958 DOI: 10.3390/diagnostics11122394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
The primary imaging modality for the diagnosis of patent ductus arteriosus (PDA) is echocardiography. However, CT may be the technique on which an incidental PDA is first recognized because of the increasing number of chest CT scans performed for a variety of causes. Identification of PDA on CT may lead to earlier closure using a PDA occluder device. Immediate identification of incidental PDA is important, but a high rate of missed diagnosis of PDA has been reported due to its small size and anatomic location. In addition, echocardiography may overlook the presence of even a large PDA due to decrease in the amount of shunting through the PDA caused by high pulmonary artery pressures. This review provides the basic CT anatomy and clinical perspective of PDA, and discusses the role of CT in the evaluation of PDA as well as methods to avoid overlooking a small PDA on CT.
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Affiliation(s)
- Soo Jeong Lee
- Department of Radiology, CHA University Kangnam Medical Ceneter, Seoul 06135, Korea;
| | - Seung Min Yoo
- Department of Radiology, CHA University Bundang Medical Ceneter, Seongnam 13497, Korea;
- Correspondence: (S.M.Y.); (C.S.W.); Tel.: +82-3-780-5423 (S.M.Y.); 410-328-0641 (C.S.W.)
| | - Min Ji Son
- Department of Radiology, CHA University Bundang Medical Ceneter, Seongnam 13497, Korea;
| | - Charles S. White
- Department of Radiology, University of Maryland, Baltimore, MD 21201, USA
- Correspondence: (S.M.Y.); (C.S.W.); Tel.: +82-3-780-5423 (S.M.Y.); 410-328-0641 (C.S.W.)
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Bedside Transcatheter Patent Ductus Arteriosus Device Occlusion in an Extremely Low Birth Weight Neonate: A Novel Approach in a High-Risk Population. Case Rep Anesthesiol 2021; 2021:4716997. [PMID: 34745665 PMCID: PMC8566062 DOI: 10.1155/2021/4716997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
Extremely low birth weight (ELBW) infants weighing less than 1 kilogram are at a high-risk for delayed patent ductus arteriosus (PDA) closure. Percutaneous PDA closure offers a less invasive approach when compared with surgical PDA closure, which may provide faster recovery times and less transfusion requirements. However, this procedure involves transporting tenuous, unstable patients from the neonatal intensive care unit (NICU) to the catheterization laboratory which introduces many potential risks for the neonate. Performing percutaneous PDA closure at the bedside offers a successful alternative to performing the procedure in the catheterization laboratory and avoiding risk associated with transporting ELBW neonates.
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Bilici M, Demir F, Akın A, Türe M, Balık H, Kuyumcu M. Transcatheter Closure of Patent Ductus Arteriosus in Children with the Occlutech Duct Occluder. Pediatr Cardiol 2017; 38:1598-1605. [PMID: 28828684 DOI: 10.1007/s00246-017-1702-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 07/28/2017] [Indexed: 11/27/2022]
Abstract
The aim of this study was to evaluate the feasibility, efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA) with the Occlutech duct occluder (ODO) in children. We reviewed the clinical records of 71 patients who underwent percutaneous closure of PDA with an ODO between September 2014 and August 2016. The Occlutech duct occluder was applied to 71 patients during the study period (September 2014-August 2016), and the results were analyzed in this study. Forty-two of the patients were female and 29 male. The median age was 20.5 months (range, 6-194 months) and median weight was 16 kg (range, 6-68 kg). The PDA was classified as type A in 54 patients (76.1%), type E in 14 (19.7%), type C in 2 (2.8%) and type B in 1 (1.4%) based on the Krichenko classification. A standard ODO device was used for the transcatheter closure procedure in 66 patients and the long-shank ODO device in 5. In the echocardiographic measurement of PDA, the median smallest diameter was 2.7 mm (range, 1.5-7.0 mm), and in the angiographic measurement, the median smallest diameter was 2.5 mm (range, 1.5-6.5 mm). All 71 patients underwent successful PDA closure with the ODO. Angiography following the procedure showed complete closure in 47 patients (66.2%), mild residual shunt in 13 patients (18.3%) and a trivial shunt in 11 patients (15.5%). Color flow Doppler echocardiogpaphy at 24 h post-implantation showed that complete closure was achieved in 65 patients (91.5%), and 6 patients (8.5%) had mild residual shunt. All patients (100%) had complete closure at 30 days of follow-up. The results of this study showed that the Occlutech PDA occluder device is safe and effective in the closure of PDA. As the pulmonary artery side of the device is wider than the aortic side, protrusion toward the aortic side and embolization are prevented, but there is residual shunt in the early period, although this residual shunt disappeared after a few months.
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Affiliation(s)
- Meki Bilici
- Department of Pediatric Cardiology, Dicle University Medical Faculty, Sur, Diyarbakır, Turkey.
| | - Fikri Demir
- Department of Pediatric Cardiology, Dicle University Medical Faculty, Sur, Diyarbakır, Turkey
| | - Alper Akın
- Department of Pediatric Cardiology, Dicle University Medical Faculty, Sur, Diyarbakır, Turkey
| | - Mehmet Türe
- Department of Pediatric Cardiology, Dicle University Medical Faculty, Sur, Diyarbakır, Turkey
| | - Hasan Balık
- Department of Pediatric Cardiology, Dicle University Medical Faculty, Sur, Diyarbakır, Turkey
| | - Mahir Kuyumcu
- Department of Anesthesiology, Dicle University Medical Faculty, Sur, Diyarbakir, Turkey
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