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Follow-up after Percutaneous Patent Ductus Arteriosus Occlusion in Lower Weight Infants

Erin Nealon1, Brian K Rivera2, Clifford L Cua1

  • 1Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH; The Heart Center, Nationwide Children's Hospital, Columbus, OH.

The Journal of Pediatrics
|July 3, 2019
PubMed

Insights

Percutaneous closure of the patent ductus arteriosus (PDA) in infants under 6 kg shows improved respiratory health long-term. However, very low weight infants face higher risks, necessitating device improvements and further trials.

Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Neonatology

Background:

  • Patent ductus arteriosus (PDA) is a common condition in premature and low-birth-weight infants.
  • Percutaneous closure of PDA has become an alternative to surgical ligation.
  • Longer-term outcomes in infants weighing less than 6 kg are not well-described.

Purpose of the Study:

  • To describe longer-term outcomes for infants weighing less than 6 kg undergoing percutaneous occlusion of the PDA.
  • To examine differences in cardiopulmonary outcomes and device-related complications between very low weight (<3 kg) and low weight (3-<6 kg) infants.

Main Methods:

  • Retrospective cohort study of infants <6 kg who underwent isolated percutaneous PDA closure.
  • Data collected from 2003-2017 at a single, tertiary center.
  • Cardiopulmonary outcomes and device-related complications were assessed using linear mixed effects models.

Main Results:

  • 92 of 106 procedures were successful. Median age and weight at procedure were 3.0 months and 3.7 kg.
  • Oxygenation failure (28% vs 8%) and decreased left ventricular systolic function (29% vs 5%) were higher in very low weight infants.
  • Pulmonary scores improved post-procedure, suggesting better respiratory status.

Conclusions:

  • Percutaneous PDA occlusion in lower weight infants may lead to long-term respiratory health improvements.
  • Higher risks of complications in very low weight infants necessitate device modification.
  • Clinical trials comparing percutaneous closure with alternative treatments are needed before widespread adoption.
Abstract

Keywords:
infantpatent ductus arteriosuspercutaneous (catheter-based) treatment

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