Cardiorespiratory Instability after Percutaneous Patent Ductus Arteriosus Closure: A Multicenter Cohort Study

Area of Science:

• Neonatal Cardiology
• Interventional Cardiology
• Pediatric Critical Care

Background:

• Patent ductus arteriosus (PDA) is common in preterm infants, posing significant cardiorespiratory risks.
• Transcatheter closure is an alternative to surgical management, but its post-procedural effects require evaluation.
• Understanding clinical outcomes is crucial for optimizing care in this vulnerable population.

Purpose of the Study:

• To assess the clinical characteristics following transcatheter patent ductus arteriosus (PDA) closure in preterm infants.
• To identify the incidence of post-procedural cardiorespiratory complications.
• To characterize the specific features of post-transcatheter cardiorespiratory syndrome.

Main Methods:

• Multicenter retrospective cohort study.
• Included preterm infants ≤2 kg undergoing percutaneous PDA closure (August 2018 - July 2021).
• Collected cardiorespiratory stability indices pre- and post-procedure (first 24 hours); primary outcome was post-transcatheter cardiorespiratory syndrome (hemodynamic instability and/or ventilation/oxygenation failure).

Main Results:

• 197 preterm infants were analyzed (median weight 1090g).
• The primary composite outcome of post-transcatheter cardiorespiratory syndrome occurred in 46 patients (23.3%).
• Systemic hypertension and oxygenation failure were the main contributors to the composite outcome.

Conclusions:

• Post-transcatheter cardiorespiratory syndrome in preterm infants is primarily associated with systemic hypertension and oxygenation failure.
• Hypotension and the need for new inotropes/vasopressors were infrequent.
• These findings highlight specific risks to monitor after transcatheter PDA closure.