Single-Center Experience of 100 Consecutive Percutaneous Patent Ductus Arteriosus Closures in Infants ≤1000 Grams

Philip, Ranjit; Tailor, Neil; Johnson, Jason N.; Apalodimas, Leah; Cunningham, Jorden; Hoy, Judy; Waller, B. Rush; Sathanandam, Shyam

doi:10.1161/circinterventions.121.010600

Cited by 12 publications

(13 citation statements)

References 5 publications

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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%

“…The MVP‐7Q also compares favorably to the Piccolo device where tricuspid regurgitation, albeit not clinically significant, was the most common complication in preterm infants 1 . Furthermore, in the series reported by Sathanandam et al, 20 two sub‐1 kg patients developed aortic arch stenosis after the Piccolo device implantation, eventually developing coarctation and requiring transcarotid stenting, while no patients developed significant LPA stenosis.…”

Section: Discussionmentioning

confidence: 97%

“…The MVP-7Q also compares favorably to the Piccolo device where tricuspid regurgitation, albeit not clinically significant, was the most common complication in preterm infants. 1 Further advantages of the MVP include easy recapture and repositioning of the device and the absence of retention discs, which may precipitate obstruction of the LPA and/or the aortic arch. Although MVP-7Q is a relatively long device (unconstrained length of 16 mm, measured between the two radio-opaque markers on the device), mild protrusion of the device into the aorta is unlikely to cause aortic arch obstruction, since the distal 4 mm of the device toward the aorta is not covered with Gore-Tex.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…On the other hand, Ranjit et al reported their experience in percutaneous cardiac intervention in infants weighing less than 1000 g. They reported that in two infants with pulmonary atresia, pulmonary valve perforations were successfully performed [34]. The same study group also demonstrated a short procedural time and fluoroscopic exposure time in transcatheter PDA occlusion among infants weighing less than 1000 g, contributing to the growing evidence of the feasibility of transcatheter cardiac intervention in these small infants [35]. The umbilical vein route may not be suitable for PV perforation in these patients, although the umbilical vein route may be used in PDA occlusion, BAS, and pulmonary valve balloon valvuloplasty.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Intervention in Neonates Using an Umbilical Vein Approach

Wei

Lin

et al. 2021

Children

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Cardiovascular catheterization has been applied in infant treatment for several decades. To date, considerable research attention has been paid to cardiovascular catheterization in small neonates. However, peripheral vascular routes of catheterization are possible obstacles for interventionists. Umbilical vein catheterization has been reported as a route for neonates, although few attempts have been made to investigate this approach. This study aimed to retrospectively review cardiovascular intervention using the umbilical vein approach as applied to infants admitted to a tertiary center from 2017 to 2020. Details including the perinatal variables, indication diagnoses, and procedure devices were collected. The enrollment included a total of 16 cases representing 17 intervention events, with infants born at a gestation age of 22–39 weeks and body weight ranging from 478 to 3685 g at the time of the procedure. The postnatal age ranged from 1 to 27 days. The catheter sizes ranged from 4 to 11 Fr. Indications included being admitted for patent ductus arteriosus occlusion (n = 15), balloon pulmonary valvuloplasty (n = 3), balloon atrial septostomy (BAS) (n = 3), pulmonary valve (PV) perforation (n = 1), and two interventions for catheter placement for continuous venovenous hemofiltration. The success rate for cardiovascular catheterization was 88.2% (15/17). There were two patients for which cannulation failed due to ductus venosus closure: one intraabdominal hemorrhage complication during continuous venovenous hemofiltration (CVVH), and one cardiac catheterization failure of PV perforation due to failure to insert the guiding catheter into the right ventricular outflow tract. Based on these findings, we conclude that cardiac catheterization and the placement of a large-sized catheter through an umbilical vein in a small infant represents a safe and time-saving method when catheterization is required.

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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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Single-Center Experience of 100 Consecutive Percutaneous Patent Ductus Arteriosus Closures in Infants ≤1000 Grams

Cited by 12 publications

References 5 publications

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

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

Cardiovascular Intervention in Neonates Using an Umbilical Vein Approach

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

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