Chmaisse Ahmad, Swanson Kaitlin E, Ross Michael M, Cooper Matthew L, Lorant Diane E, Alexy Ryan D
Division of Cardiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, United States.
Department of Radiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, United States.
Front Pediatr. 2025 Apr 24;13:1472431. doi: 10.3389/fped.2025.1472431. eCollection 2025.
We evaluated the effect of transcatheter PDA closure (TCDC) on pulmonary edema by chest x-ray and respiratory status in preterm infants and identified factors contributing to clinical improvement.
A retrospective review of TCDC in 68 premature infants from January 2017 to June 2021. Chest x-rays were reviewed to assess pulmonary edema. Multiple clinical characteristics were also evaluated.
40% of patients weaned respiratory support. x-ray haziness change was not significantly different between groups ( = 0.086), however trended toward significance. 59% had decreased haziness and 16% had a marked decrease. Smaller, younger infants were more likely to wean support and have improved edema.
Chest x-ray haziness improved after TCDC, with smaller infants and earlier closure having more improvement. Infants with lung disease had less noticeable improved edema, indicating the difficulty to assess the hemodynamic significance of their PDA prior to closure. Further studies are needed to identify which neonates benefit most from TCDC.
我们通过胸部X光和呼吸状况评估经导管封堵动脉导管（TCDC）对早产儿肺水肿的影响，并确定有助于临床改善的因素。
对2017年1月至2021年6月期间68例早产儿进行TCDC的回顾性研究。回顾胸部X光片以评估肺水肿情况。还评估了多种临床特征。
40%的患者撤掉了呼吸支持。两组之间X光片模糊度变化无显著差异（P = 0.086），但有显著趋势。59%的患者模糊度降低，16%的患者显著降低。更小、更年幼的婴儿更有可能撤掉支持并改善水肿情况。
TCDC后胸部X光片模糊度有所改善，婴儿越小且封堵越早改善越明显。患有肺部疾病的婴儿水肿改善不太明显，这表明在封堵前难以评估其动脉导管未闭的血流动力学意义。需要进一步研究以确定哪些新生儿从TCDC中获益最大。
