Percutaneous Closure of Patent Ductus Arteriosus in Infants 1.5 kg or Less: A Meta-Analysis

Bischoff, Adrianne Rahde; Jasani, Bonny; Sathanandam, Shyam; Backes, Carl H.; Weisz, Dany E.; McNamara, Patrick J.

doi:10.1016/j.jpeds.2020.10.035

Cited by 42 publications

(26 citation statements)

References 81 publications

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“…In recent years, there has been a growing interest in utilizing transcatheter patent ductus arteriosus (PDA) closure in extremely low birth weight (ELBW) infants as a less invasive alternative to surgical ligation and a more effective treatment option compared to medical therapy [1][2][3]. With increased procedural experience a modified technique for transcatheter PDA closure was developed to minimize adverse events in ELBW infants [4][5][6]. The modified implant technique avoids arterial access and exclusively utilizes a transvenous antegrade approach guided by fluoroscopy, venous angiography, and transthoracic echocardiography (TTE) with placement of the entire device within an intraductal position to avoid aortic and pulmonary artery protrusion [7,8].…”

Section: Introductionmentioning

confidence: 99%

Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants

et al. 2021

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Transcatheter closure of patent ductus arteriosus (PDA) in premature infants is a feasible, safe, and an effective alternative to surgical ligation and may be performed with an implant success rate of 97%. Major procedural complications related to transcatheter PDA closure in extremely low birth weight (ELBW) infants are relatively infrequent (< 3%) ,but may be associated with a fatality if not optimally managed. Operators performing transcatheter PDA closures should be knowledgeable about these potential complications and management options. Prompt recognition and treatment are often necessary to avoid serious consequences. With strict guidelines on operator training, proctoring requirements, and technical refinements, transcatheter PDA closure in ELBW infants can be performed safely with low complication rates. This article summarizes the consensus guidelines put forward by a panel of physicians for the prevention and management of periprocedural complications of transcatheter PDA closure with the Amplatzer Piccolo Occluder in ELBW infants.

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Section: Introductionmentioning

confidence: 99%

Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants

et al. 2021

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“…PDA occlusion using the MVP‐7Q was attempted on 22 patients (12 male). Thirteen patients in our cohort were reported in other series 1–6,13 . The median gestational age at birth was 26 weeks (IQR = 24.5–28 weeks) and the median birthweight was 800 g (IQR = 572–1075 g).…”

Section: Resultsmentioning

confidence: 87%

“…Thirteen patients in our cohort were reported in other series. [1][2][3][4][5][6]13 The median gestational age at birth was 26 weeks (IQR = 24.5-28 weeks) and the median birthweight was 800 g (IQR = 572-1075 g). Seven patients had weight ≤1 kg.…”

Section: Resultsmentioning

confidence: 99%

Use of the Medtronic Microvascular Plug 7Q for transcatheter closure of large patent ductus arteriosus in infants weighing less than 2.5 kg

Nasef

Sullivan

et al. 2022

Cathet Cardio Intervent

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Background The sole Food and Drug Administration‐approved device for transcatheter closure of the patent arterial duct in premature infants is indicated for patent ductus arteriosus (PDAs) ≤ 4 mm in diameter. We report a two‐center experience with transcatheter closure of large PDAs (>4 mm) in infants weighing <2.5 kg using the Microvascular Plug 7Q (MVP‐7Q) device. Methods This is a retrospective review of departmental databases and medical charts to define patient cohort and report demographic, procedural, and follow‐up data. Results Twenty‐two patients (12 male) with a median gestational age and birthweight of 25.5 weeks (interquartile range [IQR] = 24–28) and 800 g (572–1075), respectively, underwent attempted PDA occlusion with the MVP‐7Q using a transvenous approach. The median age and weight at the time of PDA occlusion was 32 days (IQR = 24–28) and 1100 g (IQR = 960–1700), respectively. The median PDA length was 12 mm (IQR = 11–12.65). The median PDA diameters at the aortic and pulmonary ends were 5.1 (IQR = 4.9–5.5) and 4.8 mm (IQR = 4.6–5.3), respectively. Successful device occlusion was achieved in 20 patients (91%). There were two failed attempts: One due to inappropriate sizing, and the other secondary to left pulmonary artery stenosis. There were no procedural complications and no residual shunting on follow‐up. Conclusions The MVP‐7Q is safe and effective for transcatheter closure of large (>4 mm) PDAs in infants <2.5 kg. The lack of retention disks may help with avoiding impingement on surrounding vessels.

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“…The apprehension regarding PCI in ELBW infants is due to the fear of increased procedure-related AEs, technical challenges, lack of suitable devices, and the overall care required to transport and perform a catheter-based procedure in these fragile infants [ 6 ]. With the new technology and device development in the armament of the interventionalist, PCI is being offered in a selective manner in this tenuous cohort of infants [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Additionally, improved real-time ultrasound imaging [ 17 , 18 , 19 ] and specialized transport methods for ELBW infants [ 20 ] have helped to overcome some of the challenges.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Safety of Percutaneous Cardiac Interventions for Congenital and Acquired Heart Defects in Infants ≤1000 g

et al. 2021

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The transcatheter closure of patent ductus arteriosus (TCPC) has been demonstrated to be feasible even in infants weighing ≤1000 g. However, other percutaneous cardiac interventions (PCI) for such small infants born with congenital heart defects (CHD) or acquired heart defects (AHD) have not been well described. The purpose of this study was to describe the feasibility and safety of PCI in infants ≤1000 g. A retrospective review was conducted between June 2015 and May 2021, looking at 148 consecutive PCIs performed on infants weighing ≤1000 g at the time of the procedure. The procedural success rate was 100%. The major adverse event (AE) rate for TCPC was 3%, while there were no major AEs for other PCI. It is feasible to perform PCIs in infants weighing ≤1000 g with CHD and AHD using currently available technologies.

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Percutaneous Closure of Patent Ductus Arteriosus in Infants 1.5 kg or Less: A Meta-Analysis

Cited by 42 publications

References 81 publications

Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants

Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants

Use of the Medtronic Microvascular Plug 7Q for transcatheter closure of large patent ductus arteriosus in infants weighing less than 2.5 kg

Feasibility and Safety of Percutaneous Cardiac Interventions for Congenital and Acquired Heart Defects in Infants ≤1000 g

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