Outcome after transcatheter occlusion of patent ductus arteriosus in infants less than 6 kg: A national study from United Kingdom and Ireland
Sok-Leng Kang MBBS, MRCPCH
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Search for more papers by this authorSalim Jivanji MB, ChB, MRCPH
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorChetan Mehta MBBS, MRCPCH, MD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorAndrew J. Tometzki MBChB, MRCPCH, FRCP
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Search for more papers by this authorGraham Derrick MBBS, FRCPCH, MRCP
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorRobert Yates MBBS, FRCP
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorSachin Khambadkone MBBS, MRCP, MD
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorJoseph de Giovanni MD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorOliver Stumper MD, PhD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorRami Dhillon FRCP, FRCPCH
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorVinay Bhole MRCPCH, MD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorZdenek Slavik FRCPCH, MD
Department of Paediatric Cardiology, Royal Brompton Hospital, London, England, United Kingdom
Search for more papers by this authorMichael Rigby FRCP, FRCPCH, MD
Department of Paediatric Cardiology, Royal Brompton Hospital, London, England, United Kingdom
Search for more papers by this authorPatrick Noonan MBBS, MRCPCH
Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
Search for more papers by this authorBen Smith MBBS, DCH, FRCP
Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
Search for more papers by this authorBrodie Knight MBBS, FRACP, FRACPCH
Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
Search for more papers by this authorTrevor Richens MBBS, FRCP
Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
Search for more papers by this authorNeil Wilson MD
Department of Paediatric Cardiology, Children's Hospital Colorado, Denver, Colorado
Search for more papers by this authorKevin Walsh MD
Department of Paediatric Cardiology, Our Lady's Children Hospital, Dublin, Ireland
Search for more papers by this authorAdam James MB, MRCPI
Department of Paediatric Cardiology, Our Lady's Children Hospital, Dublin, Ireland
Search for more papers by this authorJohn Thomson FRCP, MD
Department of Paediatric Cardiology, Leeds General Infirmary, Leeds, Yorkshire, United Kingdom
Search for more papers by this authorJamie Bentham MBCHB, BA, DPhil
Department of Paediatric Cardiology, Leeds General Infirmary, Leeds, Yorkshire, United Kingdom
Search for more papers by this authorNicholas Hayes MB ChB, MRCPCH
Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
Search for more papers by this authorSajid Nazir MBBS, MRCPCH
Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
Search for more papers by this authorSatish Adwani MBBS, MRCP, MD
Department of Paediatric Cardiology, Oxford University Hospitals, Oxford, England, United Kingdom
Search for more papers by this authorArjamand Shauq MBBS, MRCPCH
Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, England, United Kingdom
Search for more papers by this authorRam Ramaraj MBBS, MRCPCH
Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, England, United Kingdom
Search for more papers by this authorChristopher Duke MA ChB, FRCP
Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
Search for more papers by this authorDemetris Taliotis MBBS, MRCPCH
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Search for more papers by this authorVikram Kudumula MBBS, MRCPCH
Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
Search for more papers by this authorSan-Fui Yong MBChB, MRCPCH
Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
Search for more papers by this authorGareth Morgan MRCPCH, MPhil
Department of Paediatric Cardiology, Children's Hospital Colorado, Denver, Colorado
Search for more papers by this authorEric Rosenthal FRCP, MD
Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
Search for more papers by this authorThomas Krasemann FRCP, MD
Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
Search for more papers by this authorShakeel Qureshi MBBS, FRCP
Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
Search for more papers by this authorDavid Crossland MB ChB, MRCPCH
Department of Paediatric Cardiology, Newcastle-upon-Tyne Hospitals, Newcastle, England, United Kingdom
Search for more papers by this authorTony Hermuzi MBBS, MRCPCH
Department of Paediatric Cardiology, Newcastle-upon-Tyne Hospitals, Newcastle, England, United Kingdom
Search for more papers by this authorCorresponding Author
Robin P. Martin MBChB, FRCP, FRCPCH
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Correspondence Dr Robin P. Martin, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, England, United Kingdom. Email: [email protected]Search for more papers by this authorSok-Leng Kang MBBS, MRCPCH
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Search for more papers by this authorSalim Jivanji MB, ChB, MRCPH
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorChetan Mehta MBBS, MRCPCH, MD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorAndrew J. Tometzki MBChB, MRCPCH, FRCP
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Search for more papers by this authorGraham Derrick MBBS, FRCPCH, MRCP
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorRobert Yates MBBS, FRCP
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorSachin Khambadkone MBBS, MRCP, MD
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, England, United Kingdom
Search for more papers by this authorJoseph de Giovanni MD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorOliver Stumper MD, PhD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorRami Dhillon FRCP, FRCPCH
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorVinay Bhole MRCPCH, MD
Department of Paediatric Cardiology, Birmingham Children's Hospital, Birmingham, England, United Kingdom
Search for more papers by this authorZdenek Slavik FRCPCH, MD
Department of Paediatric Cardiology, Royal Brompton Hospital, London, England, United Kingdom
Search for more papers by this authorMichael Rigby FRCP, FRCPCH, MD
Department of Paediatric Cardiology, Royal Brompton Hospital, London, England, United Kingdom
Search for more papers by this authorPatrick Noonan MBBS, MRCPCH
Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
Search for more papers by this authorBen Smith MBBS, DCH, FRCP
Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
Search for more papers by this authorBrodie Knight MBBS, FRACP, FRACPCH
Department of Paediatric Cardiology, Royal Hospital for Children Glasgow, Glasgow, Scotland, United Kingdom
Search for more papers by this authorTrevor Richens MBBS, FRCP
Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
Search for more papers by this authorNeil Wilson MD
Department of Paediatric Cardiology, Children's Hospital Colorado, Denver, Colorado
Search for more papers by this authorKevin Walsh MD
Department of Paediatric Cardiology, Our Lady's Children Hospital, Dublin, Ireland
Search for more papers by this authorAdam James MB, MRCPI
Department of Paediatric Cardiology, Our Lady's Children Hospital, Dublin, Ireland
Search for more papers by this authorJohn Thomson FRCP, MD
Department of Paediatric Cardiology, Leeds General Infirmary, Leeds, Yorkshire, United Kingdom
Search for more papers by this authorJamie Bentham MBCHB, BA, DPhil
Department of Paediatric Cardiology, Leeds General Infirmary, Leeds, Yorkshire, United Kingdom
Search for more papers by this authorNicholas Hayes MB ChB, MRCPCH
Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
Search for more papers by this authorSajid Nazir MBBS, MRCPCH
Department of Paediatric Cardiology, Southampton General Hospital, Southampton, England, United Kingdom
Search for more papers by this authorSatish Adwani MBBS, MRCP, MD
Department of Paediatric Cardiology, Oxford University Hospitals, Oxford, England, United Kingdom
Search for more papers by this authorArjamand Shauq MBBS, MRCPCH
Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, England, United Kingdom
Search for more papers by this authorRam Ramaraj MBBS, MRCPCH
Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, England, United Kingdom
Search for more papers by this authorChristopher Duke MA ChB, FRCP
Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
Search for more papers by this authorDemetris Taliotis MBBS, MRCPCH
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Search for more papers by this authorVikram Kudumula MBBS, MRCPCH
Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
Search for more papers by this authorSan-Fui Yong MBChB, MRCPCH
Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, England, United Kingdom
Search for more papers by this authorGareth Morgan MRCPCH, MPhil
Department of Paediatric Cardiology, Children's Hospital Colorado, Denver, Colorado
Search for more papers by this authorEric Rosenthal FRCP, MD
Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
Search for more papers by this authorThomas Krasemann FRCP, MD
Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
Search for more papers by this authorShakeel Qureshi MBBS, FRCP
Department of Paediatric Cardiology, Evelina Children's Hospital, London, England, United Kingdom
Search for more papers by this authorDavid Crossland MB ChB, MRCPCH
Department of Paediatric Cardiology, Newcastle-upon-Tyne Hospitals, Newcastle, England, United Kingdom
Search for more papers by this authorTony Hermuzi MBBS, MRCPCH
Department of Paediatric Cardiology, Newcastle-upon-Tyne Hospitals, Newcastle, England, United Kingdom
Search for more papers by this authorCorresponding Author
Robin P. Martin MBChB, FRCP, FRCPCH
Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, England, United Kingdom
Correspondence Dr Robin P. Martin, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, England, United Kingdom. Email: [email protected]Search for more papers by this authorAbstract
Objectives
This study aimed to report our national experience with transcatheter patent ductus arteriosus (PDA) occlusion in infants weighing <6 kg.
Background
The technique of transcatheter PDA closure has evolved in the past two decades and is increasingly used in smaller patients but data on safety and efficacy are limited.
Methods
Patients weighing < 6 kg in whom transcatheter PDA occlusion was attempted in 13 tertiary paediatric cardiology units in the United Kingdom and Ireland were retrospectively analyzed to review the outcome and complications.
Results
A total of 408 patients underwent attempted transcatheter PDA closure between January 2004 and December 2014. The mean weight at catheterization was 4.9 ± 1.0 kg and mean age was 5.7 ± 3.0 months. Successful device implantation was achieved in 374 (92%) patients without major complication and of these, complete occlusion was achieved in 356 (95%) patients at last available follow-up. Device embolization occurred in 20 cases (5%). The incidence of device related obstruction to the left pulmonary artery or aorta and access related peripheral vascular injury were low. There were no deaths related to the procedure.
Conclusions
Transcatheter closure of PDA can be accomplished in selected infants weighing <6 kg despite the manufacturer's recommended weight limit of 6 kg for most ductal occluders. The embolization rate is higher than previously reported in larger patients. Retrievability of the occluder and duct morphology needs careful consideration before deciding whether surgical ligation or transcatheter therapy is the better treatment option.
COFLICT OF INTEREST
Dr Robin P. Martin and Dr Joseph de Giovanni have a consultancy agreement with St Jude Medical Corporation. Dr Christopher Duke is an international proctor for Occlutech with advisory role in product development. Dr John Thomson is a proctor for St Jude Medical Corporation, Occlutech and Gore medical and had a consultancy agreement with Gore and AGA Medical Corporation in the past. Professor Shakeel Qureshi is a proctor for St Jude Medical Corporation and Occlutech and had a consultancy agreement with AGA and then St Jude Medical Corporation previously. All other authors report that they have no relationships to disclose.
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