Can transcatheter PDA closure be performed in neonates ≤1000 grams? The Memphis experience

Autor: Kimberly Allen, Jason N. Johnson, B. Rush Waller, Hitesh Agrawal, Ranjit Philip, Christopher J. Knott-Craig, Shyam Sathanandam, Sandeep Chilakala
Rok vydání: 2019
Předmět:
Male
Cardiac Catheterization
medicine.medical_specialty
Septal Occluder Device
Population
Psychological intervention
Gestational Age
030204 cardiovascular system & hematology
Multidisciplinary team
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Ductus arteriosus
Humans
Medicine
Radiology
Nuclear Medicine and imaging
In patient
Cardiac Surgical Procedures
Closure (psychology)
Intensive care medicine
education
Ductus Arteriosus
Patent
education.field_of_study
business.industry
Angiography
Infant
Newborn
Outcome measures
General Medicine
Tennessee
Echocardiography
Doppler
Color
Low birth weight
Treatment Outcome
medicine.anatomical_structure
Infant
Extremely Low Birth Weight
Pediatrics
Perinatology and Child Health
Female
Surgery
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Congenital Heart Disease. 14:79-84
ISSN: 1747-079X
Popis: Objective Advancements in transcatheter technology have now made it possible to safely close patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants. The objective of this article is to describe our technique for transcatheter PDA closure (TCPC) in ELBW infants. Design The techniques employed are very specific to this population and are drastically different when compared to the procedure performed in patients weighing >5 kg. Setting A multidisciplinary team approach should be taken to evaluate and manage ELBW infants in order to achieve success. It is important that specific techniques with venous-only approach outlined in this article be followed to achieve optimal results with low risk of complications. Patients To date, in Memphis, 55 ELBW infants have had successful TCPC at a weight of ≤1000 g with minimal procedure-related complications. Interventions It is important that specific techniques with venous-only approach outlined in this article be followed to achieve optimal results with low risk of complications. Outcome measures This procedure entails a steep learning curve and should be limited to specialized centers with expertise in these thanscatheter procedures. Results There has been 100% procedural success of performing TCPC in children ≤1000 g. There have been only two procedure-related complications which happened to the first two patients, ≤1000 g, that we performed TCPC on. Conclusions It is feasible and probably safe to perform TCPC in children ≤1000 g. The techniques described in this article represent our institutional experience and have helped us improve clinical outcomes in ELBW infants.
Databáze: OpenAIRE
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