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<p>Evaluate patent ductus arteriosus (PDA) morphology changes in the preterm neonate undergoing transcatheter PDA closure (TCPC).&#xa0;We propose the&#xa0;type F ductus is associated with lower&#xa0;corrected gestational&#xa0;age (CGA) and improved TCPC&#xa0;outcomes. Retrospective review of premature neonates undergoing TCPC at a large volume institution from November 2020 to November 2023. Two independent cardiologists blindly reviewed angiograms to classify the PDA as one of the 6 published morphologies. Procedural characteristics and outcomes were compared for two cohorts of TCPC patients constituting the type F and the non-type F ductus; statistical significance set at <i>p</i>-value &lt; 0.05. 104 TCPC neonates met inclusion criteria; these were categorized as type F (<i>n</i> = 44) and non-type F (<i>n</i> = 60) ductal morphology. Patients with type F ductal morphology was associated with African American race (<i>p</i> = 0.007), lower procedural/chronological age (<i>p</i> &lt; 0.001), weight (<i>p</i> = 0.002), and CGA (<i>p</i> &lt; 0.001). Procedural length was significantly shorter in the type F group (41 vs 57&#xa0;min; <i>p</i> &lt; 0.01). Unsuccessful TCPC (<i>n</i> = 2) and device embolization (<i>n</i> = 2) events all occurred in patients with a non-type F ductal morphology. The CGA cut off &lt; 34&#xa0;weeks represents a good predictor of having a type F ductus (sensitivity 0.93, specificity 0.67). Younger chronological and&#xa0;CGA are associated with type F ductal morphology. At this institution, a type F ductus was associated with a shorter TCPC procedure time and demonstrated a lower complication rate. This data may prompt consideration of earlier TCPC referral. However, determining ideal TCPC timing in premature neonates is multifactorial and requires a multidisciplinary review team.</p>

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Patent Ductus Arteriosus Morphology Changes in Preterm Neonates Undergoing Transcatheter Device Closure

  • 期刊论文

  • 发表日期：

    2025年1月15日

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  • Megan K. Simpson,
  • Shazia Bhombal,
  • Shannon E. Hamrick,
  • Sarah Hash,
  • Marissa Adamson,
  • Zhulin He,
  • Keenan Hogan,
  • Hui Huang,
  • Andrew Jergel,
  • Dennis W. Kim,
  • Ashley S. LeFevre,
  • Marcos Mills,
  • Ashish Saini,
  • R. Allen Ligon

摘要

Evaluate patent ductus arteriosus (PDA) morphology changes in the preterm neonate undergoing transcatheter PDA closure (TCPC). We propose the type F ductus is associated with lower corrected gestational age (CGA) and improved TCPC outcomes. Retrospective review of premature neonates undergoing TCPC at a large volume institution from November 2020 to November 2023. Two independent cardiologists blindly reviewed angiograms to classify the PDA as one of the 6 published morphologies. Procedural characteristics and outcomes were compared for two cohorts of TCPC patients constituting the type F and the non-type F ductus; statistical significance set at p-value < 0.05. 104 TCPC neonates met inclusion criteria; these were categorized as type F (n = 44) and non-type F (n = 60) ductal morphology. Patients with type F ductal morphology was associated with African American race (p = 0.007), lower procedural/chronological age (p < 0.001), weight (p = 0.002), and CGA (p < 0.001). Procedural length was significantly shorter in the type F group (41 vs 57 min; p < 0.01). Unsuccessful TCPC (n = 2) and device embolization (n = 2) events all occurred in patients with a non-type F ductal morphology. The CGA cut off < 34 weeks represents a good predictor of having a type F ductus (sensitivity 0.93, specificity 0.67). Younger chronological and CGA are associated with type F ductal morphology. At this institution, a type F ductus was associated with a shorter TCPC procedure time and demonstrated a lower complication rate. This data may prompt consideration of earlier TCPC referral. However, determining ideal TCPC timing in premature neonates is multifactorial and requires a multidisciplinary review team.