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Percutaneous closure of a large patent ductus arteriosus in a preterm newborn weighing 1400 g without using arterial sheath: an innovative technique

Published online by Cambridge University Press:  13 December 2017

Gaurav Garg*
Affiliation:
Department of Pediatric Cardiology, Max Superspeciality Hospital, Shalimar Bagh, New Delhi, India
Vishal Garg
Affiliation:
Department of Cardiac Anesthesia, Max Superspeciality Hospital, Shalimar Bagh, New Delhi, India
Amit Prakash
Affiliation:
Department of Cardiac Anesthesia, Max Superspeciality Hospital, Shalimar Bagh, New Delhi, India
*
Correspondence to: G. Garg, Department of Pediatric Cardiology, Max Superspeciality Hospital, Shalimar Bagh, New Delhi, India. Tel: +91 83744 43317; Fax: +91 11 49782233; E-mail: [email protected]

Abstract

Percutaneous closure of patent ductus arteriosus is well established in infants weighing >5 kg, but data regarding outcome of preterm especially very low birth weight infants is minimal. Although surgical ligation of patent ductus arteriosus is the preferred and well-accepted modality of treatment after failure of drug therapy in preterm infants, it has also got its own demerits in such a small and fragile subset. Device closure in infants weighing <1.5 kg is rarely attempted because of high chances of complications, especially acute arterial injury due to the arterial sheath. We received a 1.4-kg ventilator-dependent infant for closure of large patent ductus arteriosus. Percutaneous closure of patent ductus arteriosus was done successfully and the infant was discharged on room air with a weight of 1.8 kg. We present here an innovative technique in which successful patent ductus arteriosus device closure was done in a 1.4-kg infant without using arterial sheath.

Type
Brief Report
Copyright
© Cambridge University Press 2017 

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References

1. Sellmer, A, Bjerre, JV, Schmidt, MR, et al. Morbidity and mortality in preterm neonates with patent ductus arteriosus on day 3. Arch Dis Child Fetal Neonatal Ed 2013; 98: F505F510.Google Scholar
2. Hamrick, SE, Hansmann, G. Patent ductus arteriosus of the preterm infant. Pediatrics 2010; 125: 10201030.Google Scholar
3. Backes, CH, Cheatham, SL, Deyo, GM, et al. Percutaneous patent ductus arteriosus (PDA) closure in very preterm infants: feasibility and complications. J Am Heart Assoc 2016; 5: e002923.CrossRefGoogle ScholarPubMed
4. Raval, MV, Laughon, MM, Bose, CL. Patent ductus arteriosus ligation in premature infants: who really benefits, and at what cost? J Pediatr Surg 2007; 42: 6975.CrossRefGoogle ScholarPubMed
5. Hammerman, C, Bin-Nun, A, Kaplan, M. Managing the patent ductus arteriosus in the premature neonate: a new look at what we thought we knew. Semin Perinatol 2012; 36: 130138.Google Scholar
6. Hsiao, C-C, Wung, J-T, Tsao, L-Y, Chang, W-C. Early or late surgical ligation of medical refractory patent ductus arteriosus in premature infants. J Formos Med Assoc 2009; 108: 7277.Google Scholar
7. Dimas, VV, Takao, C, Ing, FF, et al. Outcomes of transcatheter occlusion of patent ductus arteriosus in infants weighing ≤6 kg. JACC Cardiovasc Interv 2010; 3: 12951299.CrossRefGoogle ScholarPubMed
8. Zahn, EM, Nevin, P, Simmons, C, Garg, R. A novel technique for transcatheter patent ductus arteriosus closure in extremely preterm infants using commercially available technology. Catheter Cardiovasc Interv 2015; 85: 240248.CrossRefGoogle ScholarPubMed