Largest Single-Center Experience Using the Micro Vascular Plug (MVP) for Transcatheter Closure of Premature Patent Ductus Arteriosus.

Abstract

Within the last 5 years, the FDA approved use of the Amplatzer Piccolo Occluder (Abbot Structural Heart, CA) for transcatheter patent ductus arteriosus (PDA) closure in premature infants. Other devices have been used off-label to successfully perform this procedure, including the Microvascular Plug, "MVP" (Medtronic, Minneapolis, MN). We report the largest single-center experience with PDA closure in premature infants using the MVP device. A retrospective review of transcatheter premature infant PDA closures at a single center was performed. Procedures performed using the MVP device were included; procedures using other devices were excluded. Descriptive statistics were performed using R version 4.4.0. From 4/2018 to 8/2022, a total of 74 cases were performed. The median gestational age was 24 (IQR 23-25) weeks and procedural weight was 1.17 kg (0.97-1.40); (82% ≤ 1.5 kg). The age at procedure was 44 days (34-54). PDA minimum diameter (by angiogram) was 2.85 (2.4-3.4) mm. There were no procedural or 30-day mortalities. There was one major Adverse Event (AE) (aortic arch obstruction; 1.3%). There were two minor AEs (2.6%; small pericardial effusion requiring no intervention, n = 1; and device malposition with uneventful retrieval and replacement of additional device within the same catheterization, n = 1). The left pulmonary artery peak gradient at most recent follow-up was 5.8 (3.4-8.9) mmHg; the aortic peak gradient was 0.77 (0.4-1.7). There is a median follow-up time of 63 days (32-310) post-procedure. The safety profile using the MVP is in line with or favorable compared to the contemporary literature of PDA closure in premature infants.