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SCAI Position Statement on Transcatheter Occlusion of Patent Ductus Arteriosus in Premature Infants
Sarosh P Batlivala1, Dana Boucek2, Tacy Downing3
1Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
Insights
Transcatheter device closure is a new option for patent ductus arteriosus (PDA) in premature infants. Careful patient selection and procedural planning are crucial for safe and effective outcomes.
Area of Science:
- Neonatal cardiology
- Interventional cardiology
- Pediatric cardiovascular interventions
Background:
- Patent ductus arteriosus (PDA) historically managed with pharmacotherapy or surgical ligation.
- Transcatheter PDA occlusion device approved by FDA in 2019 for low birth weight infants.
- Emerging treatment modality with a need for standardized best practices.
Purpose of the Study:
- Provide comprehensive suggestions for optimizing transcatheter PDA occlusion safety and efficacy in premature infants.
- Establish guidelines for patient selection, procedural considerations, operator training, and institutional requirements.
- Improve long-term outcomes for premature infants with PDA.
Main Methods:
- Development of a position statement by the Society for Cardiovascular Angiography & Interventions.
- Review of current evidence and clinical experience with transcatheter PDA occlusion.
- Multidisciplinary expert consensus on best practices.
Main Results:
- Short-term outcomes of transcatheter PDA occlusion are encouraging.
- Successful outcomes depend on meticulous patient selection and procedural execution.
- A multidisciplinary approach and shared decision-making enhance safety and efficacy.
Conclusions:
- Transcatheter PDA occlusion offers a promising alternative to traditional therapies.
- Adherence to recommended guidelines is essential for maximizing patient benefit.
- Optimizing the use of this technology can significantly improve outcomes in vulnerable premature infants.
Abstract:
Historically, pharmacotherapy and surgical ligation have been the primary treatments for occlusion of patent ductus arteriosus (PDA), but recent advancements have led to the US Food and Drug Administration approval of the first transcatheter PDA occlusion device for low birth weight infants in 2019. Although short-term outcomes have been encouraging, successful outcomes are highly dependent on proper patient selection, awareness of key procedural considerations, appropriately trained operators, and institutions meeting a standard of required infrastructural requirements. A multidisciplinary approach involving neonatologists and cardiologists is beneficial, as well as shared decision-making with the patient's family. This position statement from the Society for Cardiovascular Angiography & Interventions provides comprehensive suggestions to optimize the safety and efficacy of transcatheter PDA occlusion in premature infants, aiming to improve long-term outcomes in this vulnerable population.
