Abstract
Background
To investigate the concurrent, long-term, and future adverse events and assess the trend of adverse events in pediatric patients with patent ductus arteriosus (PDA) after transcatheter closure.
Methods
A total of 1590 patients underwent transcatheter PDA closure were enrolled, including 465 patients (median age = 22 months) in the training group and 1125 patients in the validation group. Logistic regression analysis was used to assess independent risk factors associated with concurrent adverse events after closure. The chi-square test was used to evaluate the 5-year follow-up trend.
Results
Multivariable logistic regression analysis indicated that low age, female, and high pulmonary end diameter were independent risk factors for concurrent adverse events after closure. For patients without concurrent adverse events and for those who with concurrent adverse events but return to normal, the Chi-square test showed no abnormal results at the 5-year follow-up. Furthermore, the follow-up data of the validation group were not significantly different from those of the training group.
Conclusion
The value of long-term follow-up of children may be limited for those who did not have a concurrent adverse event after closure nor for those who had a concurrent adverse event after closure but returned to normal during the 5-year follow-up period.
Impact
-
Follow-up monitoring of adverse events tended to be recommended in pediatric patients with PDA after transcatheter closure. However, follow-up in these pediatric patients is expensive and there is a risk of sedation for echocardiography examination frequently.
-
·Patients who had no concurrent adverse events after closure did not show any abnormality at 5-year follow-up.
-
·Most of the patients who had concurrent adverse events after closure returned to normal at 5-year follow-up.
-
The value of long-term follow-up may be limited for the above patients after transcatheter PDA closure.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 14 print issues and online access
$259.00 per year
only $18.50 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Gentile, R. et al. Pulsed Doppler echocardiographic determination of time of ductal closure in normal newborn infants. J. Pediatr. 98, 443–448 (1981).
Schneider, D. J. The patent ductus arteriosus in term infants, children, and adults. Semin. Perinatol. 36, 146–153 (2012).
Baumgartner, H. et al. ESC guidelines for the management of grown‐up congenital heart disease (new version 2010). Eur. Heart J. 31, 2915–2957 (2010).
Baddour, L. M. et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 132, 1435–1486 (2015).
Backes, C. H. et al. Patent ductus arteriosus: a contemporary perspective for the pediatric and adult cardiac care provider. J. Am. Heart Assoc. 11, e025784 (2022).
Schneider, D. J. & Moore, J. W. Patent ductus arteriosus. Circulation 114, 1873–1882 (2006).
Bilkis, A. A. et al. The Amplatzer duct occluder: experience in 209 patients. J. Am. Coll. Cardiol. 37, 258–261 (2001).
Bhalgat, P. S., Pinto, R. & Dalvi, B. V. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: short and intermediate term results. Ann. Pediatr. Cardiol. 5, 135–140 (2012).
Feltes, T. F. et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 123, 2607–2652 (2011).
Bischoff, A. R., Kennedy, K. F., Backes, C. H., Sathanandam, S. & McNamara, P. J. Percutaneous closure of the patent ductus arteriosus in infants ≤2 kg: IMPACT registry insights. Pediatrics 152, e2023061460 (2023).
Magee, A. G. et al. Transcatheter coil occlusion of the arterial duct; results of the European Registry. Eur. Heart J. 22, 1817–1821 (2001).
Pass, R. H. et al. Multicenter USA Amplatzer patent ductus arteriosus occlusion device trial:initial and one-year results. J. Am. Coll. Cardiol. 44, 513–519 (2004).
Jang, G. Y., Son, C. S., Lee, J. W., Lee, J. Y. & Kim, S. J. Complications after transcatheter closure of patent ductus arteriosus. J. Korean Med. Sci. 22, 484–490 (2007).
Sinha, S. K., Razi, M. & Pandey, R. N. Prospective evaluation of the feasibility, safety, and efficacy of Cocoon Duct Occluder for transcatheter closure of large patent ductus arteriosus: a single-center study with short- and medium-term follow-up results. Anatol. J. Cardiol. 18, 321–327 (2017).
Stern, K. W. et al. Unplanned repeat echocardiography with sedation in children: patient risk factors. Pediatr. Cardiol. 37, 1057–1063 (2016).
El-Said, H. G. et al. Safety of percutaneous patent ductus arteriosus closure: an unselected multicenter population experience. AHA J. 2, e000424 (2013).
Nour, A., Abdelrazik, Y., Huessin, S. & Kamel, H. Safety and efficacy of percutaneous patent ductus arteriosus closure: a multicenter Egyptian experience. Egypt Heart J. 74, 14 (2022).
Pass, R. H. et al. Multicenter USA Amplatzer patent ductus arteriosus occlusion device trial: initial and one-year results. J. Am. Coll. Cardiol. 44, 513–519 (2004).
Boehm, W., Emmel, M. & Sreeram, N. The Amplatzer duct occluder for PDA closure: indications, technique of implantation and clinical outcome. Images Paediatr. Cardiol. 9, 16–26 (2007).
Bu, H. et al. A novel biodegradable occluder for the closure of ventricular septal defects: immediate and medium-term results in a canine model. Interact. Cardiovasc. Thorac. Surg. 29, 783–792 (2019).
Amoozgar, H. et al. Hemolysis and its outcome following percutaneous closure of cardiac defects among children and adolescents: a prospective study. Ital. J. Pediatr. 45, 128 (2019).
Reo, R. et al. Utility of follow-up echocardiograms in uncomplicated PDA device closures performed after infancy. Cardiol. Ther. 11, 445–452 (2022).
Acknowledgements
The authors wish to thank all participants of the study.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Contributions
Y.P. made substantial contributions to the conception and design of this study, acquisition of data, analysis and interpretation of data, and drafting the manuscript. Z.L.C. made substantial contributions to the acquisition of data. Q.J.Y. and Y.Z. made substantial contributions to revise the manuscript critically for important intellectual content. All authors reviewed the manuscript.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Peng, Y., Cheng, Z., Zhang, Y. et al. Long term follow-up of patients with patent ductus arteriosus after transcatheter closure. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03317-x
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41390-024-03317-x
