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Patent ductus arteriosus closure in infants weighing less than 1500 g via a tiny microcatheter: a simple technique
Bassel Mohammad Nijres1,2, Thomas Panicucci2
1Pediatric Cardiology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.
Background:
Despite patent ductus arteriosus closure in premature infants is a relatively fast procedure, it involves specific steps for equipment exchange and the use of a 4-Fr catheter, which may be large for tiny infants, potentially causing haemodynamic instability or tricuspid valve regurgitation.
Objectives:
This study aims to describe the early experience with a new technique designed to simplify transcatheter patent ductus arteriosus closure in premature infants. It enables the closure using the KA micro plug device via a single microcatheter without equipment exchanges and contrast exposure. This technique involves a simple modification of the microcatheter by creating a curved tip.
Methods:
This is a retrospective, single-institution study involving premature infants who underwent attempted transcatheter patent ductus arteriosus closure using a manually modified microcatheter of the KA micro plug device at Stead Family Children's Hospital.
Results:
Five patients underwent transcatheter patent ductus arteriosus closure using a KA micro plug with a modified microcatheter. The procedure was successful in all patients, with no haemodynamic instability. The median (range) for procedural weight, time, and radiation dose were 1055 g (730-1330), 12 minutes (11-19), and 0.49 µGy.m2 (0.14-1), respectively. At a median follow-up of 1.1 months (0.17-2.6), all patients maintained good device position without residual shunt or other concerning echocardiogram findings.
Conclusions:
Transcatheter patent ductus arteriosus closure in infants weighing less than 1500 g can be successfully performed using a KA micro plug device through a microcatheter with zero-contrast use, low radiation exposure, and a short procedure time.

