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Patent ductus arteriosus closure in infants weighing less than 1500 g via a tiny microcatheter: a simple technique with zero-contrast exposure

Published online by Cambridge University Press:  30 January 2025

Bassel Mohammad Nijres Open the ORCID record for Bassel Mohammad Nijres [Opens in a new window]  and
Thomas Panicucci
Bassel Mohammad Nijres*
Affiliation:
Pediatric Cardiology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia Pediatric Cardiology, Stead Family Children’s Hospital, University of Iowa, Iowa City, IA, USA
Thomas Panicucci
Affiliation:
Pediatric Cardiology, Stead Family Children’s Hospital, University of Iowa, Iowa City, IA, USA
*
Corresponding author: Bassel Mohammad Nijres; Email: [email protected]
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Abstract

Background:

Despite patent ductus arteriosus closure in premature infants is a relatively fast procedure, it involves specific steps for equipment exchange and the use of a 4-Fr catheter, which may be large for tiny infants, potentially causing haemodynamic instability or tricuspid valve regurgitation.

Objectives:

This study aims to describe the early experience with a new technique designed to simplify transcatheter patent ductus arteriosus closure in premature infants. It enables the closure using the KA micro plug device via a single microcatheter without equipment exchanges and contrast exposure. This technique involves a simple modification of the microcatheter by creating a curved tip.

Methods:

This is a retrospective, single-institution study involving premature infants who underwent attempted transcatheter patent ductus arteriosus closure using a manually modified microcatheter of the KA micro plug device at Stead Family Children’s Hospital.

Results:

Five patients underwent transcatheter patent ductus arteriosus closure using a KA micro plug with a modified microcatheter. The procedure was successful in all patients, with no haemodynamic instability. The median (range) for procedural weight, time, and radiation dose were 1055 g (730–1330), 12 minutes (11–19), and 0.49 µGy.m2 (0.14–1), respectively. At a median follow-up of 1.1 months (0.17–2.6), all patients maintained good device position without residual shunt or other concerning echocardiogram findings.

Conclusions:

Transcatheter patent ductus arteriosus closure in infants weighing less than 1500 g can be successfully performed using a KA micro plug device through a microcatheter with zero-contrast use, low radiation exposure, and a short procedure time.

Keywords

patent ductus arteriosus closurepremature infantsKA micro plug
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 6
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

Noori, S, McCoy, M, Friedlich, P, et al. Failure of ductus arteriosus closure is associated with increased mortality in preterm infants. Pediatrics 2009; 123 ( 1): e138–e144.CrossRefGoogle ScholarPubMed
Dollberg, S, Lusky, A, Reichman, B. Patent ductus arteriosus, indomethacin and necrotizing enterocolitis in very low birth weight infants: a population-based study. J Pediatr Gastroenterol Nutr 2005; 40 ( 2 ): 184–188.Google ScholarPubMed
Gentle, SJ, Travers, CP, Clark, M, Carlo, WA, Ambalavanan, N. Patent ductus arteriosus and development of bronchopulmonary dysplasia-associated pulmonary hypertension. Am J Respir Crit Care Med 2023; 207 ( 7): 921–928.CrossRefGoogle ScholarPubMed
Sathanandam, SK, Gutfinger, D, O’Brien, L, et al. Amplatzer Piccolo Occluder clinical trial for percutaneous closure of the patent ductus arteriosus in patients >/=700 grams. Catheter Cardiovasc Interv 2020; 96 ( 6 ): 1266–1276.CrossRefGoogle ScholarPubMed
Dalby, ST, Shibbani, K, Mercadante, A, et al. Transcatheter patent ductus arteriosus closure in premature infants: a multicenter retrospective study comparing available devices. Circ Cardiovasc Interv 2024; 17 ( 3 ): e013723.CrossRefGoogle ScholarPubMed
Guyon, P, Duster, N, Katheria, A, et al. Institutional trend in device selection for transcatheter PDA closure in premature infants. Pediatr Cardiol 2022; 43 ( 8 ): 1716–1722.CrossRefGoogle ScholarPubMed
Shibbani, K, Mohammad Nijres, B, McLennan, D, et al. Feasibility, safety, and short-term outcomes of transcatheter patent ductus arteriosus closure in premature infants on high-frequency jet ventilation. J Am Heart Assoc 2022; 11 ( 10 ): e025343.CrossRefGoogle ScholarPubMed
Mohammad Nijres, B, Hassan, M, Winsdor, J, Bischoff, AR, McNamara, PJ, Aldoss, O. Patent ductus arteriosus closure in small infants weighing less than 1500 g using KA micro plug: steps and tips. Cardiol Young 2024; 34 ( 8 ): 1–6.Google ScholarPubMed
Heyden, CM, El-Said, HG, Moore, JW, Guyon, PW Jr, Katheria, AC, Ratnayaka, K. Early experience with the Micro Plug Set for preterm patent ductus arteriosus closure. Catheter Cardiovasc Interv 2020; 96 ( 7 ): 1439–1444.CrossRefGoogle ScholarPubMed
Mohammad Nijres, B, Khallaf, M, Rahde Bischoff, A, et al. Transcatheter patent ductus arteriosus closure in premature infants: comparison of echocardiogram and angiogram measurements. Pediatr Cardiol 2024. DOI: 10.1007/s00246-024-03620-8.CrossRefGoogle Scholar
Paudel, G, Johnson, JN, Philip, R, et al. Echocardiographic versus angiographic measurement of the patent ductus arteriosus in extremely low birth weight infants and the utility of echo guidance for transcatheter closure. J Am Soc Echocardiogr 2021; 34 ( 10 ): 1086–1094.CrossRefGoogle ScholarPubMed
Johnson, JN, Sathanandam, S, Naik, R, Philip, R. Echocardiographic guidance for transcatheter patent ductus arteriosus closure in extremely low birth weight infants. Congenit Heart Dis 2019; 14 ( 1 ): 74–78.CrossRefGoogle ScholarPubMed
Baruteau, AE, Méot, M, Benbrik, N, et al. Device closure of hemodynamically significant patent ductus arteriosus in premature infants. JACC Adv 2024; 3 ( 10 ): 101211.CrossRefGoogle ScholarPubMed
Parkerson, S, Sathanandam, S, Molloy, A. Patent ductus arteriosus occlusion in premature infants. Interv Cardiol Clin 2024; 13 ( 3 ): 355–368. DOI: 10.1016/j.iccl.2024.02.001.Google ScholarPubMed
Georgiev, S, Tanase, D, Eicken, A, et al. Mobile bedside ductus arteriosus closure in severely premature neonates using only echocardiographic guidance. Catheter Cardiovasc Interv 2024; 103 ( 6 ): 934–942. DOI: 10.1002/ccd.31046.CrossRefGoogle ScholarPubMed
Sathanandam, S, Justino, H, Waller, BR, Radtke, W, Qureshi, AM. Initial clinical experience with the Medtronic Micro Vascular PlugTM in transcatheter occlusion of PDAs in extremely premature infants. Catheter Cardiovasc Interv 2017; 89 ( 6 ): 1051–1058.CrossRefGoogle Scholar
Philip, R, Tailor, N, Johnson, JN, et al. Single-center experience of 100 consecutive percutaneous patent ductus arteriosus closures in infants ≤1000 grams. Circ Cardiovasc Interv 2021; 14 ( 6 ): e010600.CrossRefGoogle ScholarPubMed
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