Closure Of Patent Ductus Arteriosus In Infants Research Articles

Safety and Short-Term Outcomes for Infants < 2.5kg Undergoing PDA Device Closure: A C3PO Registry Study.

To evaluate short-term procedural outcomes and safety for infants < 2.5kg who underwent catheterization with intended patent ductus arteriosus (PDA) device closure in a multi-center registry, as performance of this procedure becomes widespread. A multi-center retrospective review was performed using data from the Congenital Cardiac Catheterization Project on Outcomes (C3PO) registry. Data were collected for all intended cases of PDA closure in infants < 2.5kg from April 2019 to December 2020 at 13 participating sites. Successful device closure was defined as device placement at the conclusion of the catheterization. Procedural outcomes and adverse events (AE) were described, and associations between patient characteristics, procedural outcomes and AEs were analyzed. During the study period, 300 cases were performed with a median weight of 1.0kg (range 0.7-2.4). Successful device closure was achieved in 98.7% of cases with a 1.7% incidence of level 4/5 AEs, including one periprocedural mortality. Neither failed device placement nor adverse events were significantly associated with patient age, weight or institutional volume. Higher incidence of adverse events associated with patients who had non-cardiac problems (p = 0.017) and cases with multiple devices attempted (p = 0.064). Transcatheter PDA closure in small infants can be performed with excellent short-term outcomes and safety across institutions with variable case volume.

Spontaneous Closure of Patent Ductus Arteriosus in an Adult Patient: A Case Report

Patent Ductus Arteriosus (PDA) is a well-described congenital heart disease in infants and children but is less commonly reported in adults. Mechanical, surgical and spontaneous closure of PDAs in infants and fetuses are common, however spontaneous closure of PDA in adults is uncommon and has not been reported in the recent literature. We present a case report of spontaneous closure of a PDA in a 49 years old patient demonstrated on cardiac computed tomography (CT).

Natural evolution of patent ductus arteriosus in the extremely preterm infant

ObjectiveThe persistence of the patent ductus arteriosus (PDA) is frequently encountered in very preterm infants. Neither preventive nor curative treatments of PDA have been shown to improve the outcome of...

325 Percutaneous closure of the patent ductus arteriosus with the Amplatzer duct occluder in infants weighing ≤ 6 kg

Percutaneous closure of patent ductus arteriosus (PDA) using the Amplatzer duct occluder (ADO) is an effective and a true alternative to surgical closure. However, closure of PDA in infants with a low weight remains challenging for the interventionist. From April 1999 to February 2009, 203 patients underwent percutaneous PDA closure. We focus here on the 17 infants weighing ≤ 6 kg and in whom duct was closed using the ADO. All patients were symptomatic: failure to thrive, dyspnoea, and frequent respiratory infections. There were 15 females and 2 males. At implantation, the mean age was 5.1 ± 4 months, and the mean weight was 4.6 ± 0.9 (range 2.8 to 6 kg). The procedure was realized under local anaesthesia (n = 14) and general anaesthesia (n = 3). In 5 of the 17 pts, implantation was performed from a sole venous femoral access without arterial puncture and device release was controlled by transthoracic echocardiography. Size of the duct was 3.6 ± 1.3 mm (range 1.7 to 6 mm) and systolic pulmonary artery pressure was 54 ± 19 mm Hg (range 26 to 96 mm Hg). Implantation succeeded in all but one without any adverse event. Closure was performed by six 5/4 mm ADO, five 6/4 mm ADO, five 8/6 mm ADO, and one 10/8 mm ADO. One patient with failed procedure underwent subsequently surgical closure of the duct. During follow-up (0 to 58 months), Doppler echocardiography showed decrease in ductal shunting: complete occlusion was noticed in 5 pts at day one, 10 pts at one month, 14 pts at 3 months, and 16 pts at one year after implantation. No patient but one had persistent pulmonary hypertension and only one had a moderate stenosis on the left pulmonary artery due to device protrusion. One patient died 15 months after implantation from a non related device cause. In skilled hands, percutaneous closure of large PDA in symptomatic infants weighing ≤ 6 kg is safe and effective. Such procedure can solve clinical problems and offer a real alternative to the classic surgical correction.

Transcatheter Closure of Moderate-to-Large Patent Ductus Arteriosus in Infants Using Amplatzer Duct Occluder

There are difficulties in transcatheter closure of patent ductus arteriosus (PDA) in infants. The 46 infants (mean age 6.2+/-2.7 months; mean body weight 6.3+/-1.6 kg) who underwent PDA closure using the Amplatzer duct occluder (ADO). The indication for using an ADO was a ductus diameter > or =2.5 or 3 mm. Device diameter selected was 1-3 mm larger than ductal diameter. The mean systolic pulmonary artery pressure was 40.9+/-18.2 mmHg. The mean Qp/Qs ratio was 3.1+/-1.2. The mean ductus diameter was 3.3+/-0.8 mm. ADO was successfully deployed in 45 patients. Failure occurred in 1 case. The mean diameter of device used was 5.4+/-1.1 mm. No severe complications occurred. At the 1-month echocardiographic follow-up, a small residual shunt was present in 4 of 45 patients and had disappeared in all 4 patients at the 3-month follow-up. One patient developed a moderate degree of left ventricular outflow tract obstruction 2.3 years after the procedure. Transcatheter closure of PDA in infants using the ADO is a safe and effective method.

Ibuprofen Preferable to Indomethacin for Closure of PDA in Infants

Patent ductus arteriosus (PDA) occurs commonly in premature infants with respiratory distress syndrome. Although indomethacin is the standard