Open Access

ARTICLE

A comprehensive program for preterm infants with patent ductus arteriosus

by

Department of Pediatric Cardiology, University of Tennessee Health Science Center, LeBonheur Children’s Hospital, Memphis, Tennessee

* Corresponding Author: Leah Apalodimas, MSN, CPNP, Le Bonheur Children’s Hospital, University of Tennessee, 49 North Dunlap, 3rd Floor, Memphis, TN 38103 Email:

Congenital Heart Disease 2019, 14(1), 90-94. https://doi.org/10.1111/chd.12705

Abstract

Objectives: Patent ductus arteriosus (PDA) is a common finding in preterm infants. A hemodynamically significant PDA may require intervention for closure. This article aims to describe a transcatheter PDA closure (TCPC) program for preterm infants and the components of a comprehensive outpatient follow-up strategy.
Setting: A multidisciplinary team approach including neonatology, cardiology, anesthesiology, medical transport team, pulmonology, cardiac surgery, neurodevelopmental specialist, nutrition, speech therapy, social work, research collaborators, and other health care specialists is integral to the dedicated care and promotion of wellness of extremely low birth weight (ELBW) infants.
Patients: To date, we have performed TCPC on 134 ELBW infants weighing <2 kg at the time of the procedure, 54 of whom were <1 kg with the smallest weighing 640 g with a median gestation age of 25 weeks (range 23-27 weeks).
Interventions: A comprehensive follow-up strategy with the creation of the Memphis PDA Clinic was implemented.
Outcome measures: Respiratory support, tolerance of enteral feeds, growth, and neurodevelopmental progress are indicators of favorable outcomes.
Results: TCPC has benefited ELBW infants with faster weaning off the ventilator, increase in enteral feedings, and somatic growth with the overall shortening of the hospital length of stay. The Memphis PDA Clinic has ensured optimal postdischarge follow-up to improve long-term outcomes.
Conclusions: TCPC is a safe and effective alternative to manage ELBW infants with a hemodynamically significant PDA. Comprehensive follow-up after discharge provided in a multispecialty clinic developed specifically for this unique population has been successful in improving outcomes.

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