Venous-Only Approach for Transcatheter Patent Ductus Arteriosus Closure in Infants: Is It Time for Change?

Area of Science:

• Cardiology
• Pediatric Cardiology
• Interventional Cardiology

Background:

• The standard transcatheter closure of patent ductus arteriosus (TC-PDA) necessitates arterial access, posing a risk of arterial injury.
• A venous-only approach for TC-PDA has been successfully performed in premature infants without arterial access.

Purpose of the Study:

• To evaluate the safety and effectiveness of a venous-only approach for TC-PDA closure in infants.
• To determine if PDA closure can be achieved without arterial access in this population.

Main Methods:

• A single-center, retrospective study included 150 infants (2-10 kg) undergoing TC-PDA between January 2019 and December 2024.
• Patients were treated with either the standard arterial approach or a venous-only approach.
• Exclusion criteria included concurrent procedures and complex heart disease.

Main Results:

• The venous-only group (91 patients) showed no pulse loss, while 1.7% in the standard group (59 patients) experienced arterial injury.
• The venous-only cohort had lower radiation exposure, reduced contrast use, and shorter procedure/sheath times.
• No significant differences were observed in other adverse procedural outcomes or PDA diameter.

Conclusions:

• The venous-only approach for TC-PDA in infants is equally effective and efficient compared to the standard method.
• Eliminating arterial access with the venous-only approach enhances safety by preventing arterial injury in small infants.