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Short- and medium-term outcomes for patent ductus arteriosus stenting in neonates ≤2.5 kg with duct-dependent pulmonary circulation.
Nasef, Mohamed Al; Shahbah, Doaa A; Batlivala, Sarosh P; Darwich, Reem; Qureshi, Athar M; Breatnach, Colm R; Linnane, Niall; Walsh, Kevin P; Oslizlok, Paul; McCrossan, Brian; Momenah, Tarek; Alshahri, Atif; Abdulhamed, Jassim; Arafat, Amr; Tamimi, Omar Al; Diraneyya, Obayda M; Goldstein, Bryan H; Kenny, Damien.
Affiliation
  • Nasef MA; Children Health Ireland at Crumlin, Dublin, Ireland.
  • Shahbah DA; Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia.
  • Batlivala SP; The Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
  • Darwich R; Department of Pediatric Cardiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
  • Qureshi AM; Department of Pediatric Cardiology Department, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
  • Breatnach CR; Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia.
  • Linnane N; The Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
  • Walsh KP; Children Health Ireland at Crumlin, Dublin, Ireland.
  • Oslizlok P; Children Health Ireland at Crumlin, Dublin, Ireland.
  • McCrossan B; Children Health Ireland at Crumlin, Dublin, Ireland.
  • Momenah T; Children Health Ireland at Crumlin, Dublin, Ireland.
  • Alshahri A; Children Health Ireland at Crumlin, Dublin, Ireland.
  • Abdulhamed J; Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia.
  • Arafat A; Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia.
  • Tamimi OA; Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia.
  • Diraneyya OM; Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia.
  • Goldstein BH; Department of Cardothoracic Surgery, Tanta University, Tanta, Egypt.
  • Kenny D; Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia.
Catheter Cardiovasc Interv ; 100(4): 596-605, 2022 10.
Article in En | MEDLINE | ID: mdl-35904221
ABSTRACT

BACKGROUND:

Morbidity with surgical systemic-to-pulmonary artery shunting (SPS) in infants ≤2.5 kg has remained high. Patent ductus arteriosus (PDA) stenting may be a valid alternative. The objective of this study is to evaluate outcomes following PDA stenting in patients ≤2.5 kg from four large tertiary centers.

METHODS:

Retrospective review of all neonates ≤2.5 kg with duct-dependent pulmonary circulation who underwent PDA stenting. Procedural details, pulmonary arterial growth, reinterventions, surgery type, and outcomes were assessed.

RESULTS:

PDA stents were implanted in 37 of 38 patients attempted (18 female) at a median procedural weight of 2.2 kg (interquartile range [IQR], 2-2.4 kg). Seven patients (18%) had a genetic abnormality and 16 (42%) had associated comorbidities. The median intensive care unit stay was 4 days (IQR, 2-6.75 days), and the median hospital stay was 20 days (IQR, 16-57.25). One patient required a rescue shunt procedure, with three others requiring early SPS (<30 days postprocedure). Twenty patients (54%) required reintervention with either balloon angioplasty, restenting, or both. At 6-month follow-up, right pulmonary artery growth (median z-score -1.16 to 0.01, p = 0.05) was greater than the left pulmonary artery (median z-score -0.9 to -0.64, p = 0.35). Serious adverse effects (SAEs) were seen in 18% (N = 7) of our cohort. One patient developed an SAE during planned reintervention There were no intraprocedural deaths, with one early procedure-related mortality, and three interstage mortalities not directly related to PDA stenting.

CONCLUSIONS:

PDA stenting in infants ≤2.5 kg is feasible and effective, promoting pulmonary artery growth. Reintervention rates are relatively high, though many are planned to allow for optimal growth before a definitive operation.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ductus Arteriosus / Ductus Arteriosus, Patent Type of study: Observational_studies Limits: Female / Humans / Infant / Newborn Language: En Journal: Catheter Cardiovasc Interv Journal subject: CARDIOLOGIA Year: 2022 Document type: Article Affiliation country: Irlanda

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ductus Arteriosus / Ductus Arteriosus, Patent Type of study: Observational_studies Limits: Female / Humans / Infant / Newborn Language: En Journal: Catheter Cardiovasc Interv Journal subject: CARDIOLOGIA Year: 2022 Document type: Article Affiliation country: Irlanda