Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation
Background Prolonged exposure to a hemodynamically significant patent ductus arteriosus (PDA) is associated with major morbidity, particularly in infants born at <27 weeks’ gestation. High‐frequency jet ventilation (HFJV) is a standard of care at our center. There are no data about transcatheter...
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| Format: | Article |
| Language: | English |
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Wiley
2022-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.025343 |
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| author | Kamel Shibbani Bassel Mohammad Nijres Daniel McLennan Adrianne Rahde Bischoff Regan Giesinger Patrick J. McNamara Jonathan Klein Jimmy Windsor Osamah Aldoss |
| author_facet | Kamel Shibbani Bassel Mohammad Nijres Daniel McLennan Adrianne Rahde Bischoff Regan Giesinger Patrick J. McNamara Jonathan Klein Jimmy Windsor Osamah Aldoss |
| author_sort | Kamel Shibbani |
| collection | DOAJ |
| description | Background Prolonged exposure to a hemodynamically significant patent ductus arteriosus (PDA) is associated with major morbidity, particularly in infants born at <27 weeks’ gestation. High‐frequency jet ventilation (HFJV) is a standard of care at our center. There are no data about transcatheter PDA closure while on HFJV. The aim of this study was to assess the feasibility, safety, and outcomes of HFJV during transcatheter PDA closure. Methods and Results This is a retrospective cohort study of premature infants undergoing transcatheter device closure on HFJV. The primary outcome was successful device placement. Secondary outcomes included procedure time, fluoroscopy time and dose, time off unit, device complications, need for escalation in respiratory support, and 7‐day survival. Subgroup comparative evaluation of patients managed with HFJV versus a small cohort of patients managed with conventional mechanical ventilation was performed. Thirty‐eight patients were included in the study. Median age and median weight at PDA device closure for the HFJV cohort were 32 days (interquartile range, 25.25–42.0 days) and 1115 g (interquartile range, 885–1310 g), respectively. There was successful device placement in 100% of patients. There were no device complications noted. The time off unit and the procedure time were not significantly different between the HFJV group and the conventional ventilation group. Infants managed by HFJV had shorter median fluoroscopy times (4.5 versus 6.1 minutes; P<0.05) and no increased risk of adverse respiratory outcomes. Conclusions Transcatheter PDA closure in premature infants on HFJV is a safe and effective approach that does not compromise device placement success rate and does not lead to secondary complications. |
| first_indexed | 2024-04-10T04:35:00Z |
| format | Article |
| id | doaj.art-4a01c912569b44e580f3f58bc44a1282 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T04:35:00Z |
| publishDate | 2022-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-4a01c912569b44e580f3f58bc44a12822023-03-10T04:02:36ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-05-01111010.1161/JAHA.122.025343Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet VentilationKamel Shibbani0Bassel Mohammad Nijres1Daniel McLennan2Adrianne Rahde Bischoff3Regan Giesinger4Patrick J. McNamara5Jonathan Klein6Jimmy Windsor7Osamah Aldoss8Division of Pediatric Cardiology Stead Family Children’s Hospital University of Iowa Iowa City IADivision of Pediatric Cardiology Stead Family Children’s Hospital University of Iowa Iowa City IADivision of Pediatric Cardiology Stead Family Children’s Hospital University of Iowa Iowa City IADivision of Neonatology Stead Family Children’s Hospital University of Iowa Iowa City IADivision of Neonatology Stead Family Children’s Hospital University of Iowa Iowa City IADivision of Pediatric Cardiology Stead Family Children’s Hospital University of Iowa Iowa City IADivision of Neonatology Stead Family Children’s Hospital University of Iowa Iowa City IADivision of Pediatric Anesthesia University of Iowa Carver College of Medicine Iowa City IADivision of Pediatric Cardiology Stead Family Children’s Hospital University of Iowa Iowa City IABackground Prolonged exposure to a hemodynamically significant patent ductus arteriosus (PDA) is associated with major morbidity, particularly in infants born at <27 weeks’ gestation. High‐frequency jet ventilation (HFJV) is a standard of care at our center. There are no data about transcatheter PDA closure while on HFJV. The aim of this study was to assess the feasibility, safety, and outcomes of HFJV during transcatheter PDA closure. Methods and Results This is a retrospective cohort study of premature infants undergoing transcatheter device closure on HFJV. The primary outcome was successful device placement. Secondary outcomes included procedure time, fluoroscopy time and dose, time off unit, device complications, need for escalation in respiratory support, and 7‐day survival. Subgroup comparative evaluation of patients managed with HFJV versus a small cohort of patients managed with conventional mechanical ventilation was performed. Thirty‐eight patients were included in the study. Median age and median weight at PDA device closure for the HFJV cohort were 32 days (interquartile range, 25.25–42.0 days) and 1115 g (interquartile range, 885–1310 g), respectively. There was successful device placement in 100% of patients. There were no device complications noted. The time off unit and the procedure time were not significantly different between the HFJV group and the conventional ventilation group. Infants managed by HFJV had shorter median fluoroscopy times (4.5 versus 6.1 minutes; P<0.05) and no increased risk of adverse respiratory outcomes. Conclusions Transcatheter PDA closure in premature infants on HFJV is a safe and effective approach that does not compromise device placement success rate and does not lead to secondary complications.https://www.ahajournals.org/doi/10.1161/JAHA.122.025343device closurehigh‐frequency jet ventilatorhigh‐frequency ventilationpatent ductus arteriosustranscatheter |
| spellingShingle | Kamel Shibbani Bassel Mohammad Nijres Daniel McLennan Adrianne Rahde Bischoff Regan Giesinger Patrick J. McNamara Jonathan Klein Jimmy Windsor Osamah Aldoss Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease device closure high‐frequency jet ventilator high‐frequency ventilation patent ductus arteriosus transcatheter |
| title | Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation |
| title_full | Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation |
| title_fullStr | Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation |
| title_full_unstemmed | Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation |
| title_short | Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation |
| title_sort | feasibility safety and short term outcomes of transcatheter patent ductus arteriosus closure in premature infants on high frequency jet ventilation |
| topic | device closure high‐frequency jet ventilator high‐frequency ventilation patent ductus arteriosus transcatheter |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.025343 |
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