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Updated: Aug 29, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Utility of Follow-Up Echocardiograms in Uncomplicated PDA Device Closures Performed During Infancy
Erin Van Pelt1, Rachel Reo1, Casey Lovelace1
1Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Follow-up echocardiograms for infants after uncomplicated patent ductus arteriosus (PDA) device closure show stable or improved parameters. This suggests current lifelong TTE guidelines may be simplified for this patient group.
Area of Science:
- Pediatric Cardiology
- Medical Devices
- Diagnostic Imaging
Background:
- Lifelong transthoracic echocardiograms (TTE) are recommended after catheter-based patent ductus arteriosus (PDA) device closure.
- The clinical utility of routine TTE follow-up in infants with uncomplicated PDA closure requires further investigation.
Purpose of the Study:
- To evaluate the necessity and impact of follow-up TTE in infants who underwent uncomplicated PDA device closure.
- To assess the long-term stability of echocardiographic parameters post-PDA closure.
Main Methods:
- Retrospective chart review of 147 infants undergoing PDA closure before one year of age (2002-2020).
- Exclusion criteria included other congenital heart disease and inadequate follow-up TTE.
- Analysis of TTE parameters at multiple time points, including at least 3 months post-procedure.
Main Results:
- No significant difference in descending aorta (DAo) velocity was observed between initial and most recent TTE.
- Left pulmonary artery (LPA) velocity and left ventricular diastolic Z score significantly improved over time.
- Seventy-eight patients had repeat echocardiograms >1 year post-procedure without changes in clinical management; no interventions were performed for LPA or DAo stenosis.
Conclusions:
- Transthoracic echocardiogram parameters remain stable or improve following uncomplicated PDA device closure in infancy.
- Current lifelong TTE follow-up guidelines may be simplified for this specific pediatric population.
- Further validation in larger, longer-term studies is warranted to confirm these findings.
Introduction:
Guidelines recommend lifelong follow-up with transthoracic echocardiograms (TTE) for patients who had a patent ductus arteriosus (PDA) device closure via catheterization. The goal of this study was to determine the utility of follow-up TTE in patients who underwent an uncomplicated PDA device closure during infancy.
Methods:
Chart review was performed on patients who had a PDA closure at not more than 1 year of age between January 1, 2002 and June 1, 2020. Patients were excluded if they had other congenital heart disease, did not have a follow-up TTE at least 3 months after procedure, or had a velocity greater than 2.0 m/s in the left pulmonary artery (LPA) or descending aorta (DAo) on the first TTE at least 3 months after device placement. Time points included the first TTE after the procedure, first TTE at least 3 months after procedure, and the most recent TTE.
Results:
Total of 147 infants met the inclusion criteria. Age and weight at initial procedure were 141 ± 217 days and 4.2 ± 2.8 kg. There was no significant difference in DAo velocity between initial and most recent TTE. LPA velocity and left ventricular diastolic Z score significantly decreased between initial and most recent TTE. Seventy-eight patients had repeat echocardiograms more than 1 year after PDA procedure with no change in clinical management. No patient underwent an intervention on the LPA or DAo for stenosis.
Conclusion:
In patients who underwent an uncomplicated PDA closure during infancy, TTE parameters either stayed stable or improved over time. These findings need to be corroborated in larger studies with longer follow-up. If verified, the long-term TTE guidelines may need to be simplified for this patient population.
