Transcatheter Closure of Patent Ductus Arteriosus in infants between 2-10 kg

Yıl 2023, Cilt: 17 Sayı: 1, 30 - 38, 30.01.2023

Ahmet Vedat Kavurt , Seçil Sayın , Bilal Özelce , Denizhan Bağrul , Alper Gürsu , İbrahim Ece , İbrahim İlker Çetin

https://doi.org/10.12956/tchd.1190725

Öz

Objective: The aim of this study was to present our experiences on transcatheter patent ductus arteriosus (PDA) closure with different devices, mostly the Amplatzer Piccolo Occluder, in infants weighing between 2-10 kg.

Material and Methods: In this study, the files of 31 patients who underwent transcatheter PDA closure between December 2019 and August 2022 were reviewed retrospectively.

Results: Transcatheter PDA closure was performed on 31(14 female) infants weighing between 2-10 kg. The mean age of patients was 10.7±6.7 months (2-28), and the mean weight was 6.6±2 kg (3-9.9). The median narrowest diameter of the ductus was 2.2 mm (IQR 2-3) and the median ductus length was 6 mm (IQR 4.75-8). The procedural success rate of all interventional procedures was 88% (30 of 34). Complications occurred in a total of four patients including failure of device implantation in one patient, post-procedural device embolization in 2 patients, and the significant residual shunt in one patient. None of the patients required surgery. In 34 interventional procedures, 3 of which were reintervention, 34 devices were used. Twenty-seven (79%) of them were Amplatzer Piccolo Occluder. The median fluoroscopy and procedural times were 10.5 minutes (IQR 7.25-18.5) and 40 minutes (IQR 35-57.5) respectively. The mean duration of follow-up was 10.3±8.8 months (1-32 months).

Conclusion: In our experience, transcatheter treatment of PDA with the Amplatzer Piccolo Occluder device which was our first choice for appropriate duct anatomy and size in infants weighing between 2-10 kg, is safe and effective.

Anahtar Kelimeler

Amplatzer Piccolo Occluder, device embolization, patent ductus arteriosus, transcatheter closure, Prematüre bebek

Patent Duktus Arteriyozus 'un Transkateter Kapatılması; 2-10 kg arası bebeklerde

Öz

Amaç: Bu çalışmanın amacı, 2-10 kg arası bebeklerde çoğunlukla Amplatzer Piccolo Occluder olmak üzere farklı cihazlarla transkateter patent duktus arteriyozus (PDA) kapatma konusundaki deneyimlerimizi sunmaktır.

Gereç ve Yöntemler: Bu çalışmada Aralık 2019-Ağustos 2022 tarihleri arasında transkateter PDA kapatılan 31 hastanın dosyaları geriye dönük olarak incelendi.

Bulgular: Toplam 31(14 kadın), 2-10 kg ağırlığındaki, bebeğe transkateter PDA kapaması yapıldı. Hastaların yaş ortalaması 10.7±6.7 ay (2-28) ve ortalama ağırlık 6.6±2 kg (3-9.9)’du. Duktusun en dar ortanca çapı 2.2 mm (IQR 2-3) ve ortanca duktus uzunluğu 6 mm (IQR 4.75-8)’di. Tüm girişimsel prosedürlerin prosedürel başarı oranı %88’di (30/34). Bir hastada cihaz implantasyonu başarısızlığı, 2 hastada işlem sonrası cihaz embolizasyonu ve bir hastada önemli rezidüel şant olmak üzere toplam dört hastada komplikasyon meydana geldi. Hiçbir hastada ameliyat gerekmedi. Üçü yeniden müdahale olmak üzere 34 girişimsel işlemde 34 cihaz kullanıldı. Bunların 27’si (%79) Amplatzer Piccolo Occluder’dı. Ortanca floroskopi ve prosedür süreleri sırasıyla 10.5 dakika (IQR 7.25-18.5) ve 40 dakika (IQR 35-57.5)’dı. Hastaların ortalama takip süresi 10.3±8.8 ay (1-32 ay)’dı.

Sonuç: Deneyimlerimize göre 2-10 kg arası bebeklerde uygun duktus anatomisi ve boyutu için ilk tercihimiz olan Amplatzer Piccolo Occluder cihazı ile PDA’nın transkateter tedavisi güvenli ve etkilidir.

Anahtar Kelimeler

Amplatzer Piccolo Occluder, cihaz embolizasyonu, Prematüre bebek

Kaynakça

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