Transcatheter Patent Ductus Arteriosus Occlusion in Small Infants

Abstract

In our cohort of symptomatic infants, transcatheter PDA occlusion was successful in most and a ratio of minimum PDA diameter/length of <0.4 was predictive of technical success. Using a surrogate for pulmonary support, the majority of patients were on less support 7 days after closure.

Transcatheter Closure of a Huge Ductus Arteriosus in a Severely Ill Neonate

“…All these PDAs had Krichenko type C morphology. 3,6) Schwartz, et al 5) reported that the ratio of minimum PDA diameter/length was >0.5 in all unsuccessful cases and < 0.4 in all successful cases. In the present case, we performed successful PDA closure using AVP II even though the PDA was of type C (a diameter/length ratio of <0.4).…”

“…Hemodynamically impaired neonates with PDA occasionally show gastrointestinal, cerebral, and pulmonary complications and morbidities. 1,5) Surgical ligation of the ductus remains very risky in such neonates, although advances in perioperative intensive care have enabled cardiac surgery even in premature infants. [7][8][9][10] Several studies demonstrated feasibility and efficacy of early cardiac catheterization and transcatheter interventions in severely ill neonates with congenital heart disease.…”

“…1) Recently, successful transcatheter PDA closure using a commercially available device has been reported. 1,[3][4][5]13,14) Zahn et al 1) first reported transcatheter PDA closure using AVP II in extremely premature neonates. In their study, 6 preterm infants underwent transcatheter PDA closure using AVP II.…”

“…1) Although other similar studies have reported relatively favorable results, there were several complications, such as left pulmonary stenosis, aortic obstruction, and femoral arterial injury. [3][4][5]13) Backes, et al 3) reported that 6 of 48 infants (13%) could not undergo transcatheter PDA closure using AVP II because of left pulmonary artery or aortic obstruction. All these PDAs had Krichenko type C morphology.…”

“…4) Recently, successful transcatheter closure of PDA using AVP II in low-weight infants has been reported. 1,[3][4][5] Here, we describe a 12-day-old neonate with a huge PDA who developed pulmonary hemorrhage following disseminated intravascular clotting (DIC) and multiple organ failure (MOF). Transcatheter closure using AVP II successfully treated the huge PDA without major complications.…”