Top

Published in:

Open Access 01-08-2021 | Patent Ductus Arteriosus | Review Article

Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants

Authors: Shyam Sathanandam, Dan Gutfinger, Brian Morray, Darren Berman, Matthew Gillespie, Thomas Forbes, Jason N. Johnson, Ruchira Garg, Sophie Malekzadeh-Milani, Alain Fraisse, Osman Baspinar, Evan M. Zahn

Published in: Pediatric Cardiology | Issue 6/2021

Abstract

Transcatheter closure of patent ductus arteriosus (PDA) in premature infants is a feasible, safe, and an effective alternative to surgical ligation and may be performed with an implant success rate of 97%. Major procedural complications related to transcatheter PDA closure in extremely low birth weight (ELBW) infants are relatively infrequent (< 3%) ,but may be associated with a fatality if not optimally managed. Operators performing transcatheter PDA closures should be knowledgeable about these potential complications and management options. Prompt recognition and treatment are often necessary to avoid serious consequences. With strict guidelines on operator training, proctoring requirements, and technical refinements, transcatheter PDA closure in ELBW infants can be performed safely with low complication rates. This article summarizes the consensus guidelines put forward by a panel of physicians for the prevention and management of periprocedural complications of transcatheter PDA closure with the Amplatzer Piccolo Occluder in ELBW infants.

Sathanandam S, Agrawal H, Chilakala S et al (2019) Can transcatheter PDA closure be performed in neonates ≤1000 grams? The Memphis experience. Congenit Heart Dis 14(1):79–84CrossRef

Almeida-Jones M, Tang NY, Reddy A, Zahn E (2019) Overview of transcatheter patent ductus arteriosus closure in preterm infants. Congenit Heart Dis 14(1):60–64CrossRef

Sathanandam S, Balduf K, Chilakala S et al (2019) Role of transcatheter patent ductus arteriosus closure in extremely low birth weight infants. Catheter Cardiovasc Interv 93(1):89–96CrossRef

Fraisse A, Bautista C, Burmester M, Lane M, Singh Y (2020) Transcatheter closure of patent ductus arteriosus in infants with weight under 1,500 grams. Front Pediatr 8(2020):1–10. https://doi.org/10.3389/fped.2020.558256CrossRef

Agrawal H, Waller BR, Surendan S, Sathanandam S (2019) New patent ductus arteriosus closure devices and techniques. Intervent Cardiol Clin 8(1):23–32CrossRef

Bischoff AR, Jasani B, Sathanandam SK, Backes C, Weisz DE, McNamara PJ (2020) Percutaneous closure of patent ductus arteriosus in infants 1.5 kg or less: a meta-analysis. J Pediatr. https://doi.org/10.1016/j.jpeds.2020.10.035CrossRefPubMed

Johnson JN, Sathanandam S, Naik R et al (2019) Echocardiographic guidance for transcatheter patent ductus arteriosus closure in extremely low birth weight infants. Congenit Heart Dis 14(1):74–78CrossRef

Paudel G, Johnson JN, Philip R, Tailor N, Fahnhorst S, Briceno-Medina M, Stecchi N, Waller BR, Sathanandam S (2021) Echocardiographic versus Angiographic Measurement of the Patent Ductus Arteriosus in Extremely Low Birth Weight Infants and the Utility of Echo Guidance for Transcatheter Closure. J Am Soc Echocardiogr. https://doi.org/10.1016/j.echo.2021.06.005CrossRefPubMed

Ranjit Philip B, Waller R, Agrawal V, Wright D, Arevalo A, Zurakowski D, Sathanandam S (2016) Morphologic characterization of the patent ductus arteriosus in the premature infant and the choice of transcatheter occlusion device. Catheter Cardiovasc Interv 87(2):310–317CrossRef

10.

Sathanandam SK, Gutfinger D, O’Brien L, Forbes TJ, Gillespie MJ, Berman DP, Armstrong AK, et al (2020) Amplatzer Piccolo Occluder clinical trial for percutaneous closure of the patent ductus arteriosus in patients ≥ 700 grams. Cathet Cardiovasc Intervent 96(6):1266–1276CrossRef

11.

Vali P, Lakshminrusimha S, Pelech A, Underwood M, Ing F (2019) Patent ductus arteriosus in preterm infants: is early transcatheter closure a paradigm shift? J Perinatol 39(11):1449–1461CrossRef

12.

Backes CH, Kennedy KF, Locke M, Cua CL, Ball MK, Fick TA, Rivera BK, et al (2017) Transcatheter occlusion of the patent ductus arteriosus in 747 infants < 6 kg: insights from the NCDR IMPACT registry. JACC: Cardiovasc Intervent 10(17):1729–1737

13.

Baspinar O, Sahin DA, Sulu A, Irdem A, Gokaslan G, Sivasli E, Kilinc M (2015) Transcatheter closure of patent ductus arteriosus in under 6 kg and premature infants. J Intervent Cardiol 28(2):180–189CrossRef

14.

Ogando A, Rodríguez IP, Asensio AR, Sánchez de la Blanca F, Ballesteros Tejerizo M, Sánchez Luna JM, Gil Jaurena C, López M, Zunzunegui JL, Martínez (2018) Surgical ligation versus percutaneous closure of patent ductus arteriosus in very low-weight preterm infants: which are the real benefits of the percutaneous approach? Pediatr Cardiol 39(2):398–410CrossRef

15.

Morville P, Akhavi A (2017) Transcatheter closure of hemodynamic significant patent ductus arteriosus in 32 premature infants by amplatzer ductal occluder additional size-ADOIIAS. Catheter Cardiovasc Interv 90(4):612–617CrossRef

16.

Pamukcu O, Tuncay A, Narin N, Baykan A, Korkmaz L, Argun M, Ozyurt A, Sunkak S, Uzum K (2018) Patent ductus arteriosus closure in preterms less than 2 kg: surgery versus transcatheter. Int J Cardiol 250:110–115CrossRef

17.

Malekzadeh-Milani S, Akhavi A, Douchin S, Dauphin C, Chalard A, Mauran P, Bouvaist H, Bonnet D, Boudjemline Y (2020) Percutaneous closure of patent ductus arteriosus in premature infants: a French national survey. Catheter Cardiovasc Interv 95(1):71–77CrossRef

18.

Regan W, Benbrik N, Sharma S-R, Auriau J, Bouvaist H, Bautista C, Sirico D, et al (2020) Improved ventilation in premature babies after transcatheter versus surgical closure of patent ductus arteriosus. Int J Cardiol 311:22–27CrossRef

19.

Instructions for Use of Amplatzer Piccolo Occluder. Abbott ARTEN600042307 B; 2020–07. Available on-line at https://manuals.sjm.com/?ct=professional.

20.

Batlivala SP, Glatz AC, Gillespie MJ, Dori Y, Rome JJ (2014) Ductal spasm during performance of transcatheter ductal occlusion. Catheter Cardiovasc Interv 83(5):762–767CrossRef

21.

Alkamali A, Alasrawi S (2018) Dealing with patent ductus arteriosus (PDA) spasm in the cath lab. J Cardiol Curr Res 11(3):135–138CrossRef

22.

Tan CA, Levi DS, Moore JW (2005) Embolization and transcatheter retrieval of coils and devices. Pediatr Cardiol 26(3):267–274CrossRef

23.

Alkhouli M, Sievert H, Rihal CS (2019) Device embolization in structural heart interventions: incidence, outcomes, and retrieval techniques. JACC Cardiovasc Intervent 12(2):113–126CrossRef

24.

Tomasulo CE, Gillespie MJ, Munson D, Demkin T, O’Byrne ML, Dori Y, Smith CL, Rome JJ, Glatz AC (2020) Incidence and fate of device-related left pulmonary artery stenosis and aortic coarctation in small infants undergoing transcatheter patent ductus arteriosus closure. Catheter Cardiovasc Interv 96(4):889–897CrossRef

25.

Chien Y-H, Wang H-H, Lin M-T, Lin H-C, Chun-Wei Lu, Chiu S-N, Mei-Hwan Wu, Wang J-K, Chen C-A (2020) Device deformation and left pulmonary artery obstruction after transcatheter patent ductus arteriosus closure in preterm infants. Int J Cardiol 312:50–55CrossRef

26.

Liu F, Hsiung M-C, Song H, Dian Ke, Tang H, Liu J (2013) Unexpected co-arctation of aorta detected by transesophageal echocardiography during patent ductus arteriosus ligation. Front Med 7(2):270–273CrossRef

27.

Masri S, El Rassi I, Arabi M, Tabbakh A, Bitar F (2015) Percutaneous closure of patent ductus arteriosus in children using amplatzer duct occluder II: relationship between PDA type and risk of device protrusion into the descending aorta. Cathet Cardiovasc Intervent 86(2):E66–E72CrossRef

28.

Dimas VV, Leonard SR, Guleserian KJ, Forbess JM, Zellers TM (2010) Stent implantation for coarctation of the aorta in a premature infant through carotid cutdown as a bridge to surgical correction. J Thorac Cardiovasc Surg 139(4):1070–1071CrossRef

29.

Markush D, Tsing JC, Surbhi G, Berndsen NC, Radville G, Garg R, Zahn EM, Myriam A-J (2021) Fate of the Left Pulmonary Artery and Thoracic Aorta After Transcatheter Patent Ductus Arteriosus Closure in Low Birth Weight Premature Infants. Pediatr Cardiol 42(3): 628–636. https://doi.org/10.1007/s00246-020-02523-8CrossRef

30.

Alexander J, Yohannan T, Abutineh I et al (2016) Ultrasound-guided femoral arterial access in pediatric cardiac catheterizations: A prospective evaluation of the prevalence, risk factors, and mechanism for acute loss of arterial pulse. Catheter Cardiovasc Interv 88(7):1098–1107CrossRef

31.

Tadphale S, Yohannan T, Kauffmann T et al (2020) Accessing femoral arteries less than 3 mm in diameter is associated with increased incidence of loss of pulse following cardiac catheterization in infants. Pediatr Cardiol 41(5):1058–1066CrossRef

32.

Tadphale SD, Zurakowski D, Bird LE, Yohannan TM, Agrawal VK, Lloyd HG, Allen KJ, Waller BR, Hall AM, Sathanandam, SK (2020) Construction of femoral vessel nomograms for planning cardiac interventional procedures in children 0–4 years old. Pediatr Cardiol 41(6): 1135–1144. https://doi.org/10.1007/s00246-020-02363-6CrossRefPubMed

33.

Pan X, Hijazi ZM, Sievert H (2020) Echocardiography-Guided Interventional Patent Ductus Arteriosus Closure by Femoral Vein Approach”. In: Pan X, Hijazi ZM, Sievert H (eds) Percutaneous and Non-fluoroscopical (PAN) Procedure for Structural Heart Disease. Springer, Singapore, pp 73–77CrossRef

34.

Philip R, Waller BR, Chilakala S et al (2020) Hemodynamic and clinical consequences of early versus delayed closure of patent ductus arteriosus in extremely low birth weight infants. J Perinatol. https://doi.org/10.1038/s41372-020-00772-2CrossRefPubMed

35.

Philip R, Lamba V, Talati A, Sathanandam S (2020) Pulmonary hypertension with prolonged patency of the ductus arteriosus in preterm infants. Children 7(9):139CrossRef

36.

Sathanandam S, Whiting S, Cunningham J et al (2019) Practice variation in the management of patent ductus arteriosus in extremely low birth weight infants in the United States: Survey results among cardiologists and neonatologists. Congenit Heart Dis 14(1):6–14CrossRef

37.

Philip R, Towbin JA, Sathanandam S et al (2019) Effect of patent ductus arteriosus on the heart in preterm infants. Congenit Heart Dis 14(1):33–36CrossRef

38.

Philip R, Nathaniel Johnson J, Naik R et al (2019) Effect of patent ductus arteriosus on pulmonary vascular disease. Congenit Heart Dis 14(1):37–41CrossRef

39.

Apalodimas L, Waller BR, Philip R et al (2019) A comprehensive program for preterm infants with patent ductus arteriosus. Congenit Heart Dis 14(1):90–94CrossRef

40.

Willis A, Pereiras L, Head T et al (2019) Transport of extremely low birth weight neonates for persistent ductus arteriosus closure in the catheterization lab. Congenit Heart Dis 14(1):69–73CrossRef

41.

Sathanandam S, Gianinni A, Sefton E et al (2019) Live broadcast of transcatheter PDA closure in a 700 grams ELBW infant during the International PDA Symposium. Congenit Heart Dis 14(1):85–89CrossRef

42.

Taylor R, Forbes MJ, Kobayashi D (2020) Transcatheter closure of patent ductus arteriosus in a tiniest baby–510 grams. Prog Pediatr Cardiol 57:101189CrossRef

43.

Philip R, Tailor N, Johnson JN, Apalodimas L, Cunningham J, Hoy J, Waller III BR, Sathanandam S (2021) Single-Center Experience of 100 Consecutive Percutaneous Patent Ductus Arteriosus Closures in Infants ≤1000 Grams. Circ Cardiovasc Interv 14(6): e010600. https://doi.org/10.1161/CIRCINTERVENTIONS.121.010600CrossRefPubMed

Title: Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants
Authors: Shyam Sathanandam
Dan Gutfinger
Brian Morray
Darren Berman
Matthew Gillespie
Thomas Forbes
Jason N. Johnson
Ruchira Garg
Sophie Malekzadeh-Milani
Alain Fraisse
Osman Baspinar
Evan M. Zahn
Publication date: 01-08-2021
Publisher: Springer US
Keywords: Patent Ductus Arteriosus
Patent Ductus Arteriosus
Patent Ductus Arteriosus
Patent Ductus Arteriosus
Published in: Pediatric Cardiology / Issue 6/2021
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI: https://doi.org/10.1007/s00246-021-02665-3

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

At a glance: The STEP trials

Springer Medicine

Consensus Guidelines for the Prevention and Management of Periprocedural Complications of Transcatheter Patent Ductus Arteriosus Closure with the Amplatzer Piccolo Occluder in Extremely Low Birth Weight Infants

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2021

Epidemiology of Pediatric Heart Failure in the USA–a 15-Year Multi-Institutional Study

Sizing Up Fontan Failure: Association with Increasing Weight in Adulthood

Pediatric Cardiology Fellowship Training in Exercise Medicine: A General Needs Assessment

Total Transcatheter Stage 1: A Word of Caution

Height Versus Body Surface Area to Normalize Cardiovascular Measurements in Children Using the Pediatric Heart Network Echocardiographic Z-Score Database

Health-Related Quality of Life in Pediatric Cardiac Patients After Extracorporeal Life Support

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page