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Kang SL, Jivanji S, Mehta C, Tometzki AJ, Derrick G, Yates R, Khambadkone S, de Giovanni J, Stumper O, Dhillon R, Bhole V, Slavik Z, Rigby M, Noonan P, Smith B, Knight B, Richens T, Wilson N, Walsh K, James A, Thomson J, Bentham J, Hayes N, Nazir S, Adwani S, Shauq A, Ramaraj R, Duke C, Taliotis D, Kudumula V, Yong SF, Morgan G, Rosenthal E, Krasemann T, Qureshi S, Crossland D, Hermuzi T, Martin RP. Outcome after transcatheter occlusion of patent ductus arteriosus in infants less than 6 kg: A national study from United Kingdom and Ireland. Catheter Cardiovasc Interv 2017; 90:1135-1144. [PMID: 28799706 DOI: 10.1002/ccd.27212] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/13/2017] [Accepted: 06/25/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This study aimed to report our national experience with transcatheter patent ductus arteriosus (PDA) occlusion in infants weighing <6 kg. BACKGROUND The technique of transcatheter PDA closure has evolved in the past two decades and is increasingly used in smaller patients but data on safety and efficacy are limited. METHODS Patients weighing < 6 kg in whom transcatheter PDA occlusion was attempted in 13 tertiary paediatric cardiology units in the United Kingdom and Ireland were retrospectively analyzed to review the outcome and complications. RESULTS A total of 408 patients underwent attempted transcatheter PDA closure between January 2004 and December 2014. The mean weight at catheterization was 4.9 ± 1.0 kg and mean age was 5.7 ± 3.0 months. Successful device implantation was achieved in 374 (92%) patients without major complication and of these, complete occlusion was achieved in 356 (95%) patients at last available follow-up. Device embolization occurred in 20 cases (5%). The incidence of device related obstruction to the left pulmonary artery or aorta and access related peripheral vascular injury were low. There were no deaths related to the procedure. CONCLUSIONS Transcatheter closure of PDA can be accomplished in selected infants weighing <6 kg despite the manufacturer's recommended weight limit of 6 kg for most ductal occluders. The embolization rate is higher than previously reported in larger patients. Retrievability of the occluder and duct morphology needs careful consideration before deciding whether surgical ligation or transcatheter therapy is the better treatment option.
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Affiliation(s)
- Sok-Leng Kang
- Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
| | - Salim Jivanji
- Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
| | - Chetan Mehta
- Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
| | - Andrew J Tometzki
- Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
| | - Graham Derrick
- Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
| | - Robert Yates
- Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
| | - Sachin Khambadkone
- Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
| | - Joseph de Giovanni
- Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
| | - Oliver Stumper
- Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
| | - Rami Dhillon
- Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
| | - Vinay Bhole
- Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
| | - Zdenek Slavik
- Department of Paediatric Cardiology, Royal Brompton Hospital, London, England, United Kingdom
| | - Michael Rigby
- Department of Paediatric Cardiology, Royal Brompton Hospital, London, England, United Kingdom
| | - Patrick Noonan
- Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
| | - Ben Smith
- Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
| | - Brodie Knight
- Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
| | - Trevor Richens
- Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
| | - Neil Wilson
- Department of Paediatric Cardiology, Children's Hospital Colorado, Denver, Colorado
| | - Kevin Walsh
- Department of Paediatric Cardiology, Our Lady's Children Hospital, Dublin, Ireland
| | - Adam James
- Department of Paediatric Cardiology, Our Lady's Children Hospital, Dublin, Ireland
| | - John Thomson
- Department of Paediatric Cardiology, Leeds General Infirmary, Leeds, Yorkshire, United Kingdom
| | - Jamie Bentham
- Department of Paediatric Cardiology, Leeds General Infirmary, Leeds, Yorkshire, United Kingdom
| | - Nicholas Hayes
- Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
| | - Sajid Nazir
- Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
| | - Satish Adwani
- Department of Paediatric Cardiology, Oxford University Hospitals, Oxford, England, United Kingdom
| | - Arjamand Shauq
- Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, England, United Kingdom
| | - Ram Ramaraj
- Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, England, United Kingdom
| | - Christopher Duke
- Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
| | - Demetris Taliotis
- Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
| | - Vikram Kudumula
- Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
| | - San-Fui Yong
- Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
| | - Gareth Morgan
- Department of Paediatric Cardiology, Children's Hospital Colorado, Denver, Colorado
| | - Eric Rosenthal
- Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
| | - Thomas Krasemann
- Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
| | - Shakeel Qureshi
- Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
| | - David Crossland
- Department of Paediatric Cardiology, Newcastle-upon-Tyne Hospitals, Newcastle, England, United Kingdom
| | - Tony Hermuzi
- Department of Paediatric Cardiology, Newcastle-upon-Tyne Hospitals, Newcastle, England, United Kingdom
| | - Robin P Martin
- Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
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