Patent Ductus Arteriosus Morphology Changes in Preterm Neonates Undergoing Transcatheter Device Closure

Area of Science:

• Neonatal Cardiology
• Interventional Cardiology
• Pediatric Cardiovascular Research

Background:

• Patent ductus arteriosus (PDA) is a common condition in preterm neonates.
• Transcatheter PDA closure (TCPC) is an increasingly utilized treatment modality.
• Understanding PDA morphology is crucial for optimizing procedural outcomes.

Purpose of the Study:

• To evaluate changes in PDA morphology in preterm neonates undergoing TCPC.
• To determine the association between specific PDA morphologies (Type F) and clinical outcomes.
• To identify predictors of Type F PDA morphology.

Main Methods:

• Retrospective review of 104 preterm neonates undergoing TCPC.
• Blind angiographic classification of PDA morphology into 6 types.
• Comparison of procedural characteristics and outcomes between Type F and non-Type F PDA groups.

Main Results:

• Type F PDA morphology was associated with African American race, lower chronological age, weight, and corrected gestational age (CGA).
• TCPC procedures were significantly shorter for Type F PDAs (41 vs. 57 minutes).
• Complications, including unsuccessful closure and device embolization, occurred exclusively in the non-Type F group.

Conclusions:

• Younger chronological and corrected gestational age (CGA) are associated with Type F PDA morphology.
• Type F PDA morphology correlates with shorter TCPC procedure times and a lower complication rate.
• Earlier TCPC referral may be considered for neonates with Type F PDA, pending multidisciplinary review.