Transcatheter Closure Of PDA Research Articles

THE TRANSIENT EFFECTS OF TRANS-CATHETER PATENT DUCTUS ARTERIOSUS CLOSURE ON LEFT VENTRICULAR SYSTOLIC FUNCTION

Objectives: This study aims to measure changes in left ventricular systolic function after closure of patent ductus arteriosus and to find out echocardiographic predictors for LV dysfunction.
 Methods: A prospective study was conducted from July 01, 2021, till June 30, 2022. The study included all patients who experienced percutaneous closure of PDA in this duration. LV function was assessed before and then one day, one month and three months after the transcatheter closure. Patients with preexisting LV dysfunction and significant associated cardiac lesions were excluded from study.
 Results: PDA was occluded in 86 children by transcatheter intervention. Average age of the cohort was 65 ± 58 months with 70% female patients. The mean size of the ductus was 3.67 ± 1.78. LV systolic function remained normal in 65 patients (86%) while 21 patients (24%) suffered from a fall in systolic function of left ventricle after PDA occlusion. LVEDd, FS, and EF significantly dropped within 24 hours after occlusion of the ductus. LV- systolic dysfunction improved in almost all the patients at 3 months follow up except for 4 (4.6%) patients who had persistently poor systolic function of LV.
 Conclusion: Trans-catheter closure of PDA can cause a significant but temporary decline in LV systolic function. Large PDAd, LAd, higher PDAd/AOd, LAd/AOd and larger LV dimensions can predict LV dysfunction in high-risk patients. More prospective studies are imperative to verify these observations and to determine the predicting parameters for dysfunction of left ventricle after closure of PDA.

Vocal Cord Paralysis After Transcatheter Closure of PDA in a Preterm Infant

Vocal Cord Paralysis After Transcatheter Closure of PDA in a Preterm Infant

Successful management of patent ductus arteriosus in severely malnourished boy

Background: Patent ductus arteriosus is a vascular structure that connects the proximal descending aorta to the roof of the main pulmonary artery near the origin of the left branch pulmonary artery results in congestive heart failure, pulmonary hypertension, recurrent pneumonia and severe malnutrition. Transcatheter closure of PDA usually performed for the body weight above 6 kilograms, this is our first case in our hospital to close PDA in a child with the body weight less than 6 kilograms with satisfactory result.

Outcome Transcatether Patent Ductus Arteriosus Closure in Children

Objective: To evaluated outcome transcatether PDA closure and differentiated LVEDD, EF pre and posttranscatether PDA closure. Methods: Hospital registry was reviewed and data about patients characteristics,PDA size, device occluder and outcomes were retrieved. An descriptive analytic study with a retrospectivedesign was conducted on all medical records of PDA pediatric patients who received definitive transcatheterPDA closure at IDIK and were treated at the Department of Child Health, Dr. Soetomo Hosptal from January2017 until December 2019. The variables studied are: outcome transcatether PDA closure (complete closure,residual shunt, emboli device, obstruction pulmonaly artery, obstruction Aorta descendent, hemolysis,LVEDD and EF). Post catheterization included a follow up of immediately, 1 day, 1 month, 3 months, 6months, and 12 months after catheterization. The data were processed and statistical comparative tests werecarried out. Results: There were 101 subjects, of whom were 33 males, who underwent transcatether closureof PDA during study periode. The diameter PDA ranged from 1-7.5 mm, with median 3.4 mm. Medianage 4.3 years (4 months-18 years), median body weight was 15.4 (5 – 45) kg. Device could be deployed inall patients, in which ADO I 65%, ADO II 15%, Nit Occlude 2% and MFO 19%. Immediately Completeclosure was achieved in most patiens (92,1%) and small residual shunt (7,9%), no major complicationduring or after procedure. Most patient were discharged from hospital at 3 day after procedure. LVEDD andEF was decreased after intervention transcatether closure (P <0.05). There were no significant differences inLVEDD and EF transcatether based on closured method and sex. Conclusion: All patients showed completeclosure during followed up. Transcatheter closure of PDA is safe and effective with shorter hospitalizationand minimally complications.

Predictors for Left Ventricular Systolic Dysfunction and its Outcome after Patent Ductus Arteriosus (Pda) Closure by Device

Objective: To evaluate the predictors of left ventricle (LV) systolic dysfunction after PDA closure by device. Back ground: LV dysfunction is very common in patients after PDA closure by device. There are certain predictors leading to it. Methods: 63 patients of isolated PDA. Patients were admitted in paediatric cardiology department of National Institute of Cardiovascular Disease Karachi, Pakistan. Baseline echocardiography was performed. Hemodynamics were done during cardiac catheterization, pulmonary blood flow/systemic blood flow (QP/QS) and pulmonary vascular resistance calculated. After successful device closure echocardiography was repeated on day 1, after one, three and six months. All subjects were divided into two groups on the basis of post closure LV ejection fraction. All the parameters which include age, gender, weight, LVEDD z-score, QP, PDA size, left ventricle end diastolic pressure and pulmonary artery pressure compared in both groups. Results: 41 patients (65.1%) developed LV systolic dysfunction. Coil was used in only 3(4.8%) patients and two of them developed dysfunction. All patients recovered within six months except two had dysfunction beyond six months. 30 patients (47.6%) patients had weight Z-score <-3 SD and 29 of them developed dysfunction. Weight, base line LVEDD Z –score, QP, LVEDP and PDA size has significant impact on LV function with p-value <0.05. Conclusion: Hemodynamic effects of PDA, changes in LV dimensions and function caused by it are reversible after transcatheter closure of PDA. Large PDA size, high QP/QS are potential risk factors leading to LV dysfunction after device closure.

Transcatheter closure of PDA in premature babies less than 2 kg.

Objective:Our hypothesis was that percutaneous PDA closure in babies less than 2 kg was a safe and effective method. The aim of this study is to share our experience in transcatheter PDA closure in infants whose body weight is less than 2 kg in order to support our hypothesis.Methods:Between July 1997 and October 2014, 382 percutaneous PDA closures were done in our center. Nineteen patients who weighed less than 2 kg were included in this retrospectively study. The other inclusion criteria were 1) being symptomatic and PDA was thought as a possible contributor of medical state and 2) persistence of PDA after medical closure treatment. Patients who had sepsis and bleeding diathesis were excluded. According to size and shape of PDA, different types of devices were used such as detachable coils and Amplatzer duct occluders. Data was expressed as mean (SD) or median (minimum–maximum). Comparisons of means and medians were performed with Student’s t-test and with Mann–Whitney U test, respectively.Results:The median patient age and weight were 32 days and 1603 g (range 910–2000 g) respectively. Mean PDA diameter was 3.2±1.3 mm. Morphology of PDA was type A in 7 patients, type C in 10, type E in 1, and type B in 1 patient. There were no reported major complications. Stenosis of left pulmonary artery was detected in four patients, all of which resolved in 6 months follow-up.Conclusion:Percutaneous PDA closure in babies less than 2 kg is a safe and effective method that can be an alternative to surgery. Main distinguishing feature of this study is that it includes the largest cohort of patients less than 2 kg whose PDA closed percutaneously.

Transcatheter Closure of PDAs at the Seriously Ill premature Babies

PP-366 The aim of this stud was to evaluate our institutional experience of transcatheter closure of PDA at the seriously ill premature babies. Currently available technology is not designed for these age groups. Transcatheter occlusion of PDA at the preterm babies challenges the interventionist.

E0495 Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension in adults: two-year follow-up results

AimTo evaluate the immediate and follow-up results of transcatheter closure of large PDAs with severe pulmonary arterial hypertension (PAH) in adults.MethodAfter a complete haemodynamic evaluation differentiating from the reversibility of...

Transcatheter coil occlusion of the arterial duct. Results of the European registry

Our short-term results suggests that transcatheter closure of PDA with the Gianturco coil is safe and efficacious. However, caution should be exercised in their use in small children who require multiple coils in view of the potential complication of left pulmonary artery stenosis.

Transcatheter occlusion of native persistent ductus arteriosus using conventional Gianturco coils

Our short-term results suggests that transcatheter closure of PDA with the Gianturco coil is safe and efficacious. However, caution should be exercised in their use in small children who require multiple coils in view of the potential complication of left pulmonary artery stenosis.