Rohan Suresh Daniel^1,2, Georgia K. Schmidt^1,2, Hayato Nakanishi^1,2, Karen Smayra^1,2, Mariah N. Mascara^1,2, Dilip K. Vankayalapati^1,2, Reem H. Matar^1,2,3, Christian A. Than^1,2,4, George Shiakos⁵, Ioannis Tzanavaros^2,5,*

Congenital Heart Disease, Vol.18, No.2, pp. 245-265, 2023, DOI:10.32604/chd.2023.027596 - 15 March 2023

Abstract Background: Persistent patent ductus arteriosus (pPDA) is a common condition in preterm infants. This meta-analysis aimed to assess the safety and efficacy of transcatheter closure (TC) when compared to surgical ligation (SL) in preterm infants with pPDA. Methods: A literature search of Ovid Cochrane Library, Medline, Embase, Epub, Scopus, PMC Preprints, and was conducted from inception to May 06, 2022. Eligible studies reported infants diagnosed with pPDA born at ≤2000 g birth weight or at ≤37 weeks’ who underwent TC or SL as treatment. This review was registered in PROSPERO (CRD42022325944). Results: From 97 studies screened, 8… More >

Shibin Sun^1,#, Geoffrey J. Changwe^1,2,#, Zeeshan Farhaj¹, Hongxin Li^1,*, Yuekun Sun¹, Zhongzheng Kong¹

Congenital Heart Disease, Vol.17, No.4, pp. 437-445, 2022, DOI:10.32604/chd.2022.019943 - 04 July 2022

Abstract Background: Closure of large patent ductus arteriosus (PDA) in older children has been accomplished using surgical and percutaneous techniques with remarkable outcomes. However, outcomes amongst infants have been variable with several drawbacks. Here we describe a novel minimally invasive technique, a product of mini-thoracotomy and traditional percutaneous technique skills, accomplished exclusively under echocardiography guidance. Methods: Symptomatic infants with a significant left-to-right shunt from PDA measuring more than 4 mm were selected. The symptoms were varying degrees of tachypnea, tachycardia, heart failure, failure to thrive, recurrent respiratory tract infections, or intensive care unit treatment for a longer duration.… More >

Annina Dietrich^1,2, Daniel Quandt^1,2, Oliver Kretschmar^1,2, Walter Knirsch^1,2,*

Congenital Heart Disease, Vol.17, No.2, pp. 215-230, 2022, DOI:10.32604/CHD.2021.017232 - 26 January 2022

Abstract Objectives: To determine immediate and long-term follow-up of transcatheter closure of patent ductus arteriosus (PDA) in children. Background: National antibiotic prophylaxis (AP) guideline for infective endocarditis changed after 2009, the effect on practice of PDA closure is unknown. Methods: Observational single center study analyzing follow-up of PDA closure comparing two time periods before (2002–2009) and after (2010–2019) changes in AP guideline. Results: 332 patients (68.1% female), median (interquartile range) age 3.0 years (1.5–5.7) and body weight 14.0 kg (10.0–19.3), were enrolled. PDA morphology was conical type A (50.3%), window type B (1.2%), tubular type C (40.1%), complex type… More >

Alessia Callegari¹, Barbara Burkhardt¹, Christa Relly², Walter Knirsch¹, Martin Christmann¹

Congenital Heart Disease, Vol.14, No.4, pp. 671-677, 2019, DOI:10.1111/chd.12830

Abstract Background: Since routine clinical use of antibiotics as well as surgical and catheter‐ based closure of a patent arterial duct (PDA), PDA‐associated infective endarteritis (PDA‐IE) is rare but can still occur when the ductus is still open or as it closes. Thus, clinicians should maintain a high index of concern for patients with unexplained fever.
Methods: We report on a PDA‐IE in a young infant shortly after potentially delayed obliteration of a PDA. We discuss this case report by reviewing the literature in regard to the pathogenesis (infection primary or secondary to PDA thrombus formation), clinical (new… More >

Regan E. Giesinger¹, Adrianne R. Bischoff³, Patrick J. McNamara^1,2

Congenital Heart Disease, Vol.14, No.2, pp. 311-316, 2019, DOI:10.1111/chd.12738

Abstract Ligation of a hemodynamically significant ductus arteriosus results in significant changes in loading conditions which have predictable consequences. Postligation cardiac syndrome, defined as hypotension requiring inotropic support and failure of oxygenation and ventilation, may occur 6‐12 hours following ligation due to left ven‐ tricular systolic and diastolic failure, respectively. Afterload is the primary driver of this decompensation. In this review, we describe the pathophysiological changes in loading conditions associated with postligation cardiac syndrome and other contrib‐ utors to cardiovascular dysfunction following ductal ligation. We present strategies for perioperative optimization and a physiology‐based algorithm for postoperative More >

Shyam Sathanandam¹, Stephanie Whiting¹, Jorden Cunningham¹, David Zurakowski², Leah Apalodimas¹, B. Rush Waller¹, Ranjit Philip¹, Athar M. Qureshi³

Congenital Heart Disease, Vol.14, No.1, pp. 6-14, 2019, DOI:10.1111/chd.12729

Abstract Background: Patent ductus arteriosus (PDA) is highly prevalent in extremely low birth weight (ELBW), preterm infants. There are diverse management approaches for the PDA in ELBW infants. The objectives of this research were to identify current PDA management practices among cardiologists and neonatologists in the United States, describe any significant differences in management, and describe areas where practices align.
Methods: A survey of 10 questions based on the management of PDA in ELBW infants was conducted among 100 prominent neonatologists from 74 centers and 103 prominent cardiologists from 75 centers. Among the cardiologists, approximately 50% were interventionists… More >

Jason Nathaniel Johnson^1,2, Shyam Sathanandam¹, Ronak Naik¹, Ranjit Philip¹

Congenital Heart Disease, Vol.14, No.1, pp. 74-78, 2019, DOI:10.1111/chd.12725

Abstract Echocardiographic imaging provides real‐time guidance during transcatheter patent ductus arteriosus (PDA) closure in extremely low birth weight (ELBW) infants. Transthoracic echocardiogram provides detailed assessment of the PDA and sur‐ rounding structures prior to, during, and after transcatheter closure. This article aims to review the different echocardiographic techniques and concepts utilized during transcatheter PDA closure in ELBW infants. More >

John M. Ferguson

Congenital Heart Disease, Vol.14, No.1, pp. 52-56, 2019, DOI:10.1111/chd.12715

Abstract Even though up to 60% of premature infants less than 28 weeks gestation develop persistent patent ductus arteriosus (PDA), there remains controversy regarding if, when, and how to close the PDA. Failure to close the PDA has been associated with significant morbidity but no cause‐and‐effect has been proven for short‐term or long‐term outcomes in modern times. Surgical closure has the advantage of eliminating the PDA, but short‐term complications and long‐term adverse outcomes are worrisome. Intravenous indomethacin has been the “gold standard” for pharmacologic treatment over the past 40 years with high closure rates and decreased More >

Stacey L. Crockett, Courtney D. Berger, Elaine L. Shelton, Jeff Reese

Congenital Heart Disease, Vol.14, No.1, pp. 15-20, 2019, DOI:10.1111/chd.12714

Abstract Regulation of the ductus arteriosus, an essential fetal vessel connecting the pulmo‐ nary artery and aorta, is complex. Failure of this vessel to close after birth may result in a persistent left‐to‐right shunt through the patent ductus arteriosus, a condition associated with significant morbidities. Numerous factors contribute to the shift from fetal ductus patency to postnatal closure, requiring precise coordination of molecular cues with biomechanical forces and underlying genetic influences. Despite significant advances, questions remain regarding signaling dynamics and the natural time course of ductus closure, particularly in preterm neonates. This review highlights the contri‐ More >

Myriam Almeida‐Jones^1,2, Nai Yu Tang^1,2, Aneela Reddy³, Evan Zahn^1,2

Congenital Heart Disease, Vol.14, No.1, pp. 60-64, 2019, DOI:10.1111/chd.12712

Abstract Clinically significant patent ductus arteriosus (PDA) has been associated with signifi‐ cant morbidity in extremely low birth weight (ELBW) infants. Current management of ELBW infants with hemodynamically significant PDA includes supportive treatment, pharmacological therapy, and surgical ligation. All of these therapeutic options have their advantages and limitations. More recently, transcatheter PDA closure has been described as a viable option in this population. In this paper, we provide a compre‐ hensive review of this emerging procedure. More >