S. Malekzadeh-Milani , B. Lefort , M. Bakloul , S. Douchin , C. Dauphin , A. Akhavi , N. Benbrik , M. Meot , D. Bonnet , A. Baruteau
{"title":"早产儿经导管PDA闭合术：我们的立场是什么？法国一项前瞻性多中心调查","authors":"S. Malekzadeh-Milani , B. Lefort , M. Bakloul , S. Douchin , C. Dauphin , A. Akhavi , N. Benbrik , M. Meot , D. Bonnet , A. Baruteau","doi":"10.1016/j.acvdsp.2023.07.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Transcatheter persistent ductus arteriosus (PDA) in extremely-low-birth-weight infants has proved to be feasible and safe but midterm outcomes data are scarce. We report herein results from the French nationwide Premiclose registry.</p></div><div><h3>Objective</h3><p>We report herein results from the French nationwide Premiclose registry.</p></div><div><h3>Methods</h3><p>All infants who attempted device PDA closure at a procedural weight <<!--> <!-->2<!--> <!-->kg were prospectively included from 7 tertiary institutions between October 2017 and June 2022. Demographic and procedural data were reviewed as well as respiratory and cardiac follow-up.</p></div><div><h3>Results/Expected results</h3><p>In total, 274 patients (mean birth weight: 812<!--> <!-->±<!--> <!-->213 grams, mean gestational age: 25.8<!--> <!-->±<!--> <!-->1.9 weeks) were included. Mean procedural age and weight were 31<!--> <!-->±<!--> <!-->12 days and 1250<!--> <!-->±<!--> <span>330 grams respectively. Patients were all symptomatic with a hemodynamically significant PDA. Procedure was performed under both fluoroscopy (fluoro time: 4.5</span> <!-->±<!--> <!-->4<!--> <span><span>min) and transthoracic echocardiography guidance in all patients; 240 (87.6%) procedures were contrast free. Successful PDA closure was achieved in 97%. Complications occurred in 10 patients, with major adverse events in 3 (1.1%) consisting in </span>device embolization<span><span> in 2 and tamponnade in 1. There was no procedural death. Post ligation cardiac syndrome was noted in 4% and escalation of respiratory support in 20% of the cases. During follow-up, 8 late complications were reported with 3 patients requiring </span>aortic coarctation<span> treatment and one patient awaiting LPA stenosis treatment. Over time, significantly smaller patients were treated with significantly lower complications. Neurologic assessment is ongoing and will be presented.</span></span></span></p></div><div><h3>Conclusion/Perspectives</h3><p>Our large series confirms favorable results of transcatheter PDA closure in extremely-low-birth-weight infants, along with demonstrating learning curve, high procedural success, low procedural complications and low rate of post ligation cardiac syndrome but escalation in respiratory support. Late cardiac complications were few but long-term follow-up remains mandatory.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 4","pages":"Page 279"},"PeriodicalIF":18.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Transcatheter PDA closure in preterm: Where do we stand? A prospective multicenter French survey\",\"authors\":\"S. Malekzadeh-Milani , B. Lefort , M. Bakloul , S. Douchin , C. Dauphin , A. Akhavi , N. Benbrik , M. Meot , D. Bonnet , A. Baruteau\",\"doi\":\"10.1016/j.acvdsp.2023.07.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Transcatheter persistent ductus arteriosus (PDA) in extremely-low-birth-weight infants has proved to be feasible and safe but midterm outcomes data are scarce. We report herein results from the French nationwide Premiclose registry.</p></div><div><h3>Objective</h3><p>We report herein results from the French nationwide Premiclose registry.</p></div><div><h3>Methods</h3><p>All infants who attempted device PDA closure at a procedural weight <<!--> <!-->2<!--> <!-->kg were prospectively included from 7 tertiary institutions between October 2017 and June 2022. Demographic and procedural data were reviewed as well as respiratory and cardiac follow-up.</p></div><div><h3>Results/Expected results</h3><p>In total, 274 patients (mean birth weight: 812<!--> <!-->±<!--> <!-->213 grams, mean gestational age: 25.8<!--> <!-->±<!--> <!-->1.9 weeks) were included. Mean procedural age and weight were 31<!--> <!-->±<!--> <!-->12 days and 1250<!--> <!-->±<!--> <span>330 grams respectively. Patients were all symptomatic with a hemodynamically significant PDA. Procedure was performed under both fluoroscopy (fluoro time: 4.5</span> <!-->±<!--> <!-->4<!--> <span><span>min) and transthoracic echocardiography guidance in all patients; 240 (87.6%) procedures were contrast free. Successful PDA closure was achieved in 97%. Complications occurred in 10 patients, with major adverse events in 3 (1.1%) consisting in </span>device embolization<span><span> in 2 and tamponnade in 1. There was no procedural death. Post ligation cardiac syndrome was noted in 4% and escalation of respiratory support in 20% of the cases. During follow-up, 8 late complications were reported with 3 patients requiring </span>aortic coarctation<span> treatment and one patient awaiting LPA stenosis treatment. Over time, significantly smaller patients were treated with significantly lower complications. 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Transcatheter PDA closure in preterm: Where do we stand? A prospective multicenter French survey
Introduction
Transcatheter persistent ductus arteriosus (PDA) in extremely-low-birth-weight infants has proved to be feasible and safe but midterm outcomes data are scarce. We report herein results from the French nationwide Premiclose registry.
Objective
We report herein results from the French nationwide Premiclose registry.
Methods
All infants who attempted device PDA closure at a procedural weight < 2 kg were prospectively included from 7 tertiary institutions between October 2017 and June 2022. Demographic and procedural data were reviewed as well as respiratory and cardiac follow-up.
Results/Expected results
In total, 274 patients (mean birth weight: 812 ± 213 grams, mean gestational age: 25.8 ± 1.9 weeks) were included. Mean procedural age and weight were 31 ± 12 days and 1250 ± 330 grams respectively. Patients were all symptomatic with a hemodynamically significant PDA. Procedure was performed under both fluoroscopy (fluoro time: 4.5 ± 4 min) and transthoracic echocardiography guidance in all patients; 240 (87.6%) procedures were contrast free. Successful PDA closure was achieved in 97%. Complications occurred in 10 patients, with major adverse events in 3 (1.1%) consisting in device embolization in 2 and tamponnade in 1. There was no procedural death. Post ligation cardiac syndrome was noted in 4% and escalation of respiratory support in 20% of the cases. During follow-up, 8 late complications were reported with 3 patients requiring aortic coarctation treatment and one patient awaiting LPA stenosis treatment. Over time, significantly smaller patients were treated with significantly lower complications. Neurologic assessment is ongoing and will be presented.
Conclusion/Perspectives
Our large series confirms favorable results of transcatheter PDA closure in extremely-low-birth-weight infants, along with demonstrating learning curve, high procedural success, low procedural complications and low rate of post ligation cardiac syndrome but escalation in respiratory support. Late cardiac complications were few but long-term follow-up remains mandatory.
期刊介绍：
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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