OBJECTIVE: To test the hypothesis that transcatheter elimination of left-to-right (L-R) cardiac shunts in former premature infants with bronchopulmonary dysplasia (BPD) is feasible, safe, and is associated with an improvement in respiratory status. DESIGN: Retrospective case review. PATIENTS: Twelve patients with BPD who underwent an attempt at transcatheter closure of an L-R shunt lesion within the first year of life at a single center. Median weight was 5.4 kg and median age was 6 months. Fifteen L-R shunt lesions included patent ductus arteriosus (n = 1), atrial septal defect (ASD) (n = 9), and aortopulmonary collaterals (n = 5). OUTCOME MEASURES: Echocardiographic and clinical markers were collected before and after intervention as well as procedural variables including successful elimination of the shunt and procedural complications. RESULTS: The L-R shunts were successfully occluded in 11/12 (91.6%) patients without any significant procedural adverse event. The ASD closure group demonstrated a decrease in right heart size after the procedure. All patients required respiratory support prior to, and 1 month after, the procedure while only 5/10 (50%) required respiratory support at 12 months of age (P = .0129). There was no change in the median weight percentile over time. CONCLUSION: Transcatheter occlusion of L-R shunts can be performed safely and effectively in children with BPD. Further studies may clarify the role of such therapy in improvement in respiratory physiology over time.
OBJECTIVE: To test the hypothesis that transcatheter elimination of left-to-right (L-R) cardiac shunts in former premature infants with bronchopulmonary dysplasia (BPD) is feasible, safe, and is associated with an improvement in respiratory status. DESIGN: Retrospective case review. PATIENTS: Twelve patients with BPD who underwent an attempt at transcatheter closure of an L-R shunt lesion within the first year of life at a single center. Median weight was 5.4 kg and median age was 6 months. Fifteen L-R shunt lesions included patent ductus arteriosus (n = 1), atrial septal defect (ASD) (n = 9), and aortopulmonary collaterals (n = 5). OUTCOME MEASURES: Echocardiographic and clinical markers were collected before and after intervention as well as procedural variables including successful elimination of the shunt and procedural complications. RESULTS: The L-R shunts were successfully occluded in 11/12 (91.6%) patients without any significant procedural adverse event. The ASD closure group demonstrated a decrease in right heart size after the procedure. All patients required respiratory support prior to, and 1 month after, the procedure while only 5/10 (50%) required respiratory support at 12 months of age (P = .0129). There was no change in the median weight percentile over time. CONCLUSION: Transcatheter occlusion of L-R shunts can be performed safely and effectively in children with BPD. Further studies may clarify the role of such therapy in improvement in respiratory physiology over time.
Authors: Christopher J Petit; Henri Justino; Ricardo H Pignatelli; Matthew A Crystal; William A Payne; Frank F Ing Journal: Pediatr Cardiol Date: 2012-07-18 Impact factor: 1.655
Authors: Ram N Bishnoi; Allen D Everett; Richard E Ringel; Carl Y Owada; Ralf J Holzer; Joanne L Chisolm; Wolfgang A Radtke; D Scott Lim; John F Rhodes; John D Coulson Journal: Pediatr Cardiol Date: 2014-04-11 Impact factor: 1.655
Authors: Karan R Kumar; David A Clark; Evan M Kim; Jasmine D Perry; Kaylyn Wright; Sheikisha A Thomas; Elizabeth J Thompson; Rachel G Greenberg; P Brian Smith; Daniel K Benjamin; Matthew M Laughon; Reese H Clark; Christoph P Hornik Journal: J Pediatr Date: 2018-08-29 Impact factor: 6.314