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• W2893672365 abstract "Patent ductus arteriosus (PDA) in neonates and children sometimes requires percutaneous ligation when the left-right shunt becomes hemodynamically significant. Premature newborns are particularly prone to this condition and tend to present a different ductus morphology than full-term patients. Previous literature has established that approximately 85% of PDA patients presented with type A (conical) ductus anatomy. However, in recent years, progress in neonatology has led to an increase in premature patients’ survival, with a concomitant rise of previously rare types of PDA (mostly types C and E, both of long tubular shape). The aim of this study was to confirm the evolution of PDA shape proportions in order to guide proper patient management, as well as to secondarily reduce the risk of procedure complications. Retrospective study on serial pediatric cases who underwent percutaneous PDA closure between October 2010 and December 2017 in a tertiary care center. Patients who required coil occlusion were excluded. All catheterization reports were reviewed and abstracted. All PDA shapes were remeasured by two experienced operators and reclassified according to established nomenclature, and major device related complications were recorded. There were 123 eligible patients who underwent device closure at 2.55±0.55 years old. The proportion of type A PDA was significantly lower than what was predicted by standard literature (42.3% vs. 85%, p<0.001). The non-A PDA type increase in prevalence was unevenly distributed between near/full-term (=>36 weeks, n=92) and prematurely born (<36 weeks, n=31) patients. Premature children presented with significantly higher rate of C or E PDAs (74.2%) compared to full-term children (43.5%); p=0.04. Type B and D PDAs represent an insignificant proportion (6.5% of patients) and are beyond the scope of this study. Device protrusion was observed in 10/63 (19.5%) type C and E PDAs compared to 5/52 (11.8%) in type A patients, without reaching statistical significance however (p=0.35). Moreover, two patients suffered of device embolization, and they both presented with a type E PDA. Because of neonatal health care progress in recent years, the elongated PDAs have replaced the Type A predominance. This results in unadapted therapeutic devices, with consequently higher risk of device-related complications. These issues affect primarily the former premature patients, an increasing population. Accordingly, future device development is necessary to adapt with current requirements." @default.
• W2893672365 created "2018-10-05" @default.
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• W2893672365 date "2018-10-01" @default.
• W2893672365 modified "2023-09-25" @default.
• W2893672365 title "THE SHIFTING ANATOMY OF THE PATENT DUCTS ARTERIOSUS - A RETROSPECTIVE STUDY FROM A SINGLE TERTIARY HEART CENTER" @default.
• W2893672365 doi "https://doi.org/10.1016/j.cjca.2018.07.337" @default.
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