Utility of Follow-Up Echocardiograms in Uncomplicated PDA Device Closures Performed During Infancy.

Abstract

Guidelines recommend lifelong follow-up with transthoracic echocardiograms (TTE) for patients who had a patent ductus arteriosus (PDA) device closure via catheterization. The goal of this study was to determine the utility of follow-up TTE in patients who underwent an uncomplicated PDA device closure during infancy. Chart review was performed on patients who had a PDA closure at not more than 1year of age between January1, 2002 and June1, 2020. Patients were excluded if they had other congenital heart disease, did not have a follow-up TTE at least 3months after procedure, or had a velocity greater than 2.0m/s in the left pulmonary artery (LPA) or descending aorta (DAo) on the first TTE at least 3months after device placement. Time points included the first TTE after the procedure, first TTE at least 3months after procedure, and the most recent TTE. Total of 147 infants met the inclusion criteria. Age and weight at initial procedure were 141 ± 217days and 4.2 ± 2.8kg. There was no significant difference in DAo velocity between initial and most recent TTE. LPA velocity and left ventricular diastolic Z score significantly decreased between initial and most recent TTE. Seventy-eight patients had repeat echocardiograms more than 1year after PDA procedure with no change in clinical management. No patient underwent an intervention on the LPA or DAo for stenosis. In patients who underwent an uncomplicated PDA closure during infancy, TTE parameters either stayed stable or improved over time. These findings need to be corroborated in larger studies with longer follow-up. If verified, the long-term TTE guidelines may need to be simplified for this patient population.