William Regan1, Nadir Benbrik2, Shiv-Raj Sharma3, Johanne Auriau4, Helene Bouvaist4, Carles Bautista-Rodriguez3, Domenico Sirico3, Tuan-Chen Aw3, Giovanni di Salvo3, Sandrine Foldvari5, Jean-Christophe Rozé6, Alban-Elouen Baruteau7, Alain Fraisse8. 1. Paediatric Cardiology Services, Royal Brompton Hospital, London, UK; Department of Congenital Heart Disease, Evelina London Children's Hospital, London, UK. 2. Department of Paediatric and Congenital Cardiology, CHU Nantes, Nantes, France. 3. Paediatric Cardiology Services, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, UK. 4. Congenital Heart Team, Grenoble University Hospital, France. 5. Paediatric Cardiology Services, Royal Brompton Hospital, London, UK. 6. Neonatal Intensive Care Unit, CHU Nantes, Nantes, France. 7. Department of Paediatric and Congenital Cardiology, CHU Nantes, Nantes, France; Department of Congenital Heart Disease, Evelina London Children's Hospital, London, UK; L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France. 8. Paediatric Cardiology Services, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, UK. Electronic address: a.fraisse@rbht.nhs.uk.
Abstract
AIMS: Patent ductus arteriosus (PDA) is common in preterm infants and can contribute to morbidity and mortality. We aimed to compare results and outcome of transcatheter closure using the Amplatzer Piccolo Occluder versus surgical closure in 2 matched groups of preterm infants weighing <3000 g. METHODS AND RESULTS: A total of 147 babies from three tertiary centres were retrospectively analysed. Sixty-four babies undergoing catheter closure were compared with 83 matched surgical cases. Patent ductus arteriosus closure was successful in all cases. During neonatal unit course, mortality was 6.3% (n = 4) after catheterization and 12% (n = 10) after surgery (p = 0.24). Median duration of mechanical ventilation was shorter after catheterisation than after surgery (3 vs 5 days, p = 0.035). Before 4 weeks of age the difference between transcatheter and surgical closure for mechanical ventilation was even more pronounced (3 vs 9 days, p = 0.022). Additionally, when catheterisation was performed before 4 weeks, babies were discharged home earlier as compared to those who underwent closure later in life (39+1 vs. 42+1 weeks, p = 0.021). Such difference was not found in the surgical group. CONCLUSIONS: Transcatheter closure of patent ductus arteriosus is safe, effective and is associated with shorter mechanical ventilation than after surgery. Hospital stay might be shorter when performed earlier in life.
AIMS: Patent ductus arteriosus (PDA) is common in preterm infants and can contribute to morbidity and mortality. We aimed to compare results and outcome of transcatheter closure using the Amplatzer Piccolo Occluder versus surgical closure in 2 matched groups of preterm infants weighing <3000 g. METHODS AND RESULTS: A total of 147 babies from three tertiary centres were retrospectively analysed. Sixty-four babies undergoing catheter closure were compared with 83 matched surgical cases. Patent ductus arteriosus closure was successful in all cases. During neonatal unit course, mortality was 6.3% (n = 4) after catheterization and 12% (n = 10) after surgery (p = 0.24). Median duration of mechanical ventilation was shorter after catheterisation than after surgery (3 vs 5 days, p = 0.035). Before 4 weeks of age the difference between transcatheter and surgical closure for mechanical ventilation was even more pronounced (3 vs 9 days, p = 0.022). Additionally, when catheterisation was performed before 4 weeks, babies were discharged home earlier as compared to those who underwent closure later in life (39+1 vs. 42+1 weeks, p = 0.021). Such difference was not found in the surgical group. CONCLUSIONS: Transcatheter closure of patent ductus arteriosus is safe, effective and is associated with shorter mechanical ventilation than after surgery. Hospital stay might be shorter when performed earlier in life.
Authors: Michael T Kuntz; Steven J Staffa; Dionne Graham; David Faraoni; Philip Levy; James DiNardo; Nicola Maschietto; Viviane G Nasr Journal: J Am Heart Assoc Date: 2021-12-31 Impact factor: 6.106
Authors: Shyam Sathanandam; Dan Gutfinger; Brian Morray; Darren Berman; Matthew Gillespie; Thomas Forbes; Jason N Johnson; Ruchira Garg; Sophie Malekzadeh-Milani; Alain Fraisse; Osman Baspinar; Evan M Zahn Journal: Pediatr Cardiol Date: 2021-06-30 Impact factor: 1.655