Mohammad Nijres Bassel, Panicucci Thomas
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.
Cardiol Young. 2025 Jan 30:1-6. doi: 10.1017/S104795112500006X.
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.
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.
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.
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.m (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.
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.
尽管早产儿动脉导管未闭封堵术是一个相对快速的手术，但它涉及设备更换的特定步骤以及使用4Fr导管，对于微小婴儿来说可能较大，有可能导致血流动力学不稳定或三尖瓣反流。
本研究旨在描述一种新技术的早期经验，该技术旨在简化早产儿经导管动脉导管未闭封堵术。它能够通过单个微导管使用KA微型封堵器进行封堵，无需设备更换和造影剂暴露。该技术通过制造弯曲尖端对微导管进行简单改造。
这是一项回顾性单机构研究，纳入了在斯特德家庭儿童医院使用手动改造的KA微型封堵器微导管尝试进行经导管动脉导管未闭封堵术的早产儿。
5例患者使用改良微导管通过KA微型封堵器进行了经导管动脉导管未闭封堵术。所有患者手术均成功，无血流动力学不稳定。手术体重、时间和辐射剂量的中位数（范围）分别为1055 g（730 - 1330）、12分钟（11 - 19）和0.49 µGy.m（0.14 - 1）。在中位随访1.1个月（0.17 - 2.6）时，所有患者封堵器位置良好，无残余分流或其他令人担忧的超声心动图表现。
对于体重小于1500 g的婴儿，使用KA微型封堵器通过微导管进行经导管动脉导管未闭封堵术可以成功完成，且零造影剂使用、低辐射暴露、手术时间短。
