Pediatric cardiology Less invasive percutaneous closure of persistent arterial duct in children below 10 kilos

Kusa, Jacek; Raś, Małgorzata; Cześniewicz, Paweł; Nahirny, Robert

doi:10.5114/pwki.2013.35447

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…During the echo imaging, we have checked for the obstruction of the descending aorta and both pulmonary arteries. In the literature, there are reports of PDA closure using only the venous route in children weighing less than 10 kg ( 21 , 22 ). We have previously reported effective and reliable transvenous closure of PDA in selected cases with ADO I without femoral arterial access under the guidance of transthoracic echocardiography and aortogram in the return phase ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of PDA in premature babies less than 2 kg

et al. 2016

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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.

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Section: Discussionmentioning

confidence: 99%

Transcatheter closure of PDA in premature babies less than 2 kg

et al. 2016

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“…The percutaneous device closing in group E was done following protocols reported in other studies [ 23 , 24 ]. Briefly, the femoral vein was initially punctured and sheathed.…”

Section: Methodsmentioning

confidence: 99%

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus

Luo

Liu

Zheng

et al. 2022

BMC Cardiovasc Disord

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Background The percutaneous device closure of patent ductus arteriosus (PDA) is widely used in clinical practice, however full data on the changes in myocardial injury and systemic inflammatory markers’ levels after PDA in children are not fully reported. Methods We have conducted a retrospective analysis of the medical records of 385 pediatric patients in our hospital from January 2017 to December 2019. The patients were distributed into five groups. The first four (A, B, C and D) included patients divided by the type of the surgical closure methods, namely ligation, clamping, ligation-combined suturing and ligation-combined clamping, respectively. The fifth group E comprised of percutaneous device PDA patients. All recorded medical and trial data from the five groups were statistically studied. Results No serious complications in the patients regardless of the classification group were reported. Our results suggested that there were no considerable differences between the groups at the baseline (with all P > 0.05). Group E demonstrated a significantly smaller operative time (42.39 ± 3.88, min) and length of hospital stay (LOS) (4.49 ± 0.50, day), less intraoperative blood loss (7.12 ± 2.09, ml) while on the other hand, a higher total hospital cost (24,001.35 ± 1152.80, RMB) than the other four groups (with all P < 0.001). Interestingly, the comparison of the inflammatory factors such as white blood cells (WBC) count, C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6), as well as the myocardial injury markers (CKMB and troponin I) did not show a significant increase (P > 0.05) among the four groups. On the contrary, when the aforementioned factors and markers of all the surgical groups were compared to those in group E, we observed significantly higher speed and magnitude of changes in group E than those in groups A, B, C, and D (with all P < 0.001). Conclusion Although the percutaneous device closure of PDA is more comforting and drives fast recuperation in comparison to conventional surgery, it provokes myocardial injury and overall inflammation. Timely substantial and aggressive intervention measures such as the use of antibiotics before operation and active glucocorticoids to suppress inflammation and nourish the myocardium need be applied if the myocardial and inflammatory markers are eminent.

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“…The percutaneous device closing in group E was done following protocols reported in other studies 23,24 . Brie y, the femoral vein was initially punctured and sheathed.…”

Section: A)mentioning

confidence: 99%

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus Running Title: Myocardial and inflammatory response of patent ductus arteriosus

Luo

Liu

Zheng

et al. 2022

Preprint

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Background The percutaneous device closure of patent ductus arteriosus (PDA) is widely used in clinical practice, however full data on the changes in myocardial injury and systemic inflammatory markers’ levels after PDA in children are not fully reported. Methods We have conducted a retrospective analysis of the medical records of 385 pediatric patients in our hospital from January 2017 to December 2019. The patients were distributed into five groups. The first four (A, B, C and D) included patients divided by the type of the surgical closure methods, namely ligation, clamping, ligation-combined suturing and ligation-combined clamping, respectively. The fifth group E comprised of percutaneous device PDA patients. All recorded medical and trial data from the five groups were statistically studied. Results No serious complications in the patients regardless of the classification group were reported. Our results suggested that there were no considerable differences between the groups at the baseline (P > 0.05). Group E demonstrated a significantly smaller operative time and length of hospital stay (LOS), less intraoperative blood loss while on the other hand, a higher total hospital cost than the other four groups (P < 0.001). Interestingly, the comparison of the inflammatory factors such as white blood cells (WBC) count, C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6), as well as the myocardial injury markers (CK-MB and troponin I) did not show a significant increase ( P > 0.05) among the four groups. On the contrary, when the aforementioned factors and markers of all the surgical groups were compared to those in group E, we observed significantly higher speed and magnitude of changes in group E than those in groups A, B, C, and D (P < 0.001). Conclusion Although the percutaneous device closure of PDA is more comforting and drives fast recuperation in comparison to conventional surgery, it provokes myocardial injury and overall inflammation. Group E in our studies showcased a significant increase in the measured pro-inflammatory and myocardial injury blood markers.

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Pediatric cardiology Less invasive percutaneous closure of persistent arterial duct in children below 10 kilos

Cited by 4 publications

References 7 publications

Transcatheter closure of PDA in premature babies less than 2 kg

Transcatheter closure of PDA in premature babies less than 2 kg

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus Running Title: Myocardial and inflammatory response of patent ductus arteriosus

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