Division of Pediatric Cardiology, New York-Presbyterian - Morgan Stanley Children's Hospital, Columbia University Medical Center, 3959 Broadway, CHN-253, New York, NY, 10032, USA.
Division of Pediatric Cardiology, Medical College of Wisconsin and Herma Heart Institute at Children's Wisconsin, Milwaukee, WI, USA.
Pediatr Cardiol. 2023 Aug;44(6):1406-1413. doi: 10.1007/s00246-023-03147-4. Epub 2023 Mar 30.
To evaluate short-term procedural outcomes and safety for infants < 2.5 kg who underwent catheterization with intended patent ductus arteriosus (PDA) device closure in a multi-center registry, as performance of this procedure becomes widespread. A multi-center retrospective review was performed using data from the Congenital Cardiac Catheterization Project on Outcomes (C3PO) registry. Data were collected for all intended cases of PDA closure in infants < 2.5 kg from April 2019 to December 2020 at 13 participating sites. Successful device closure was defined as device placement at the conclusion of the catheterization. Procedural outcomes and adverse events (AE) were described, and associations between patient characteristics, procedural outcomes and AEs were analyzed. During the study period, 300 cases were performed with a median weight of 1.0 kg (range 0.7-2.4). Successful device closure was achieved in 98.7% of cases with a 1.7% incidence of level 4/5 AEs, including one periprocedural mortality. Neither failed device placement nor adverse events were significantly associated with patient age, weight or institutional volume. Higher incidence of adverse events associated with patients who had non-cardiac problems (p = 0.017) and cases with multiple devices attempted (p = 0.064). Transcatheter PDA closure in small infants can be performed with excellent short-term outcomes and safety across institutions with variable case volume.
为评估在多中心注册中心接受有创动脉导管未闭(PDA)装置闭合术的<2.5kg 婴儿的短期程序结局和安全性,因为该程序的实施越来越广泛。使用先天性心脏导管术结局(C3PO)注册中心的数据进行了多中心回顾性研究。收集了 2019 年 4 月至 2020 年 12 月在 13 个参与中心接受<2.5kg 婴儿 PDA 闭合术的所有意向病例的数据。成功的器械闭合定义为在导管插入术结束时放置器械。描述了程序结果和不良事件(AE),并分析了患者特征、程序结果和 AE 之间的关联。在研究期间,共进行了 300 例手术,中位数体重为 1.0kg(范围 0.7-2.4)。98.7%的病例成功进行了器械闭合,4/5 级 AE 的发生率为 1.7%,包括 1 例围手术期死亡。器械放置失败或不良事件与患者年龄、体重或机构数量均无显著相关性。与非心脏问题患者(p=0.017)和尝试使用多个器械的病例(p=0.064)相关的不良事件发生率较高。在具有不同病例量的机构中,对小婴儿进行经导管 PDA 闭合术可以获得出色的短期结局和安全性。