Piccolo Device for Treating Patent Ductus Arteriosus Beyond Premature Newborn Patients, a Novel Experience in South America: A Retrospective Study

Abstract

Background and Aims

Transcatheter closure of patent ductus arteriosus (PDA), particularly with the Amplatzer Piccolo Occluder, offers advantages over surgical closure, including better recovery and lower risk of complications. Although its smaller profile is preferred for neonatal endovascular closure, it may be used in patients of varying ages. This study aims to evaluate the effectiveness of the Piccolo device in PDA treatment beyond premature newborns.

Methods

A retrospective study was conducted on patients who underwent PDA closure with the Piccolo device at our institution between January 2021 and December 2023.

Results

Twenty-nine patients underwent transcatheter closure with the Piccolo device, with a mean age of 24 months (IQR: 5–23) and a mean weight of 10.4 kg (IQR: 5.6–13.8). The average ductus arteriosus diameter was 1.65 mm (IQR: 1.0–1.9), and the most commonly used device size was 4/4 mm (n = 14), followed by 5/4 mm (n = 5) and 3/4 mm (n = 4). Successful closure was achieved in 28 patients (96.5%) without evidence of persistent shunt after closure. No device embolization or local complications were observed after the procedure. One patient died during hospitalization due to unrelated complications of intestinal perforation. During follow-up of at least 6 months, no stenosis of the left pulmonary artery or aorta was identified in any patient.

Conclusion

These findings suggest a potential extension of the utility of the Piccolo device beyond the neonatal phase, demonstrating its safety and efficacy in older pediatric patients weighing over 2 kg, without a significant increase in complications or mortality rates.