Transcatheter and Surgical Ductus Arteriosus Closure in Very Low Birth Weight Infants: 2018-2022
The optimal patent ductus arteriosus (PDA) closure method in very low birth weight (VLBW) infants is uncertain. In 2019, the first transcatheter occlusion device was approved in the United States for infants ≥700 g. We described survival and short-term outcomes among VLBW infants who underwent trans...
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| Veröffentlicht in: | Pediatrics (Evanston) 2024-08, Vol.154 (2), p.1 |
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| creator | Leahy, Brianna F Edwards, Erika M Ehret, Danielle E Y Soll, Roger F Yeager, Scott B Flyer, Jonathan N |
| description | The optimal patent ductus arteriosus (PDA) closure method in very low birth weight (VLBW) infants is uncertain. In 2019, the first transcatheter occlusion device was approved in the United States for infants ≥700 g. We described survival and short-term outcomes among VLBW infants who underwent transcatheter or surgical PDA closure (2018-2022).
Vermont Oxford Network members submitted data on infants born from 401 to 1500 g or 22 to 29 weeks' gestational age. Adjusted risk ratios (aRR) for survival, length of stay (LOS), prematurity complications, and discharge support were used to compare transcatheter versus surgical closure. Subgroup analyses were conducted for infants with birth weight ≥700 g and born in 2020-2022.
Overall, 6410 of 216 267 infants at 726 hospitals received invasive PDA treatment. Transcatheter closure increased from 29.8% in 2018 to 71.7% in 2022. VLBW infants undergoing transcatheter closure had higher survival (adjusted rate ratio [aRR] 1.03; 1.02-1.04) with similar LOS (aRR 1.00; 0.97-1.03), neonatal complications (aRR 1.00; 0.98-1.01), and receipt of discharge support (aRR 0.94; 0.89-1.01). In subgroup analyses, survival (aRR 1.02; 1.00-1.04) and discharge support (aRR 0.90; 0.81-1.01) were similar between groups, whereas selected neonatal complications (aRR 0.95; 0.93-0.98) and LOS (aRR 0.95; 0.90-0.99) were lower after transcatheter closure.
Transcatheter PDA closure in VLBW infants was increasingly used after 2018. Selected short-term outcomes for infants receiving transcatheter closure may be more favorable, compared with surgical, and warrants further clinical investigation. |
| doi_str_mv | 10.1542/peds.2024-065905 |
| format | Article |
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Vermont Oxford Network members submitted data on infants born from 401 to 1500 g or 22 to 29 weeks' gestational age. Adjusted risk ratios (aRR) for survival, length of stay (LOS), prematurity complications, and discharge support were used to compare transcatheter versus surgical closure. Subgroup analyses were conducted for infants with birth weight ≥700 g and born in 2020-2022.
Overall, 6410 of 216 267 infants at 726 hospitals received invasive PDA treatment. Transcatheter closure increased from 29.8% in 2018 to 71.7% in 2022. VLBW infants undergoing transcatheter closure had higher survival (adjusted rate ratio [aRR] 1.03; 1.02-1.04) with similar LOS (aRR 1.00; 0.97-1.03), neonatal complications (aRR 1.00; 0.98-1.01), and receipt of discharge support (aRR 0.94; 0.89-1.01). In subgroup analyses, survival (aRR 1.02; 1.00-1.04) and discharge support (aRR 0.90; 0.81-1.01) were similar between groups, whereas selected neonatal complications (aRR 0.95; 0.93-0.98) and LOS (aRR 0.95; 0.90-0.99) were lower after transcatheter closure.
Transcatheter PDA closure in VLBW infants was increasingly used after 2018. Selected short-term outcomes for infants receiving transcatheter closure may be more favorable, compared with surgical, and warrants further clinical investigation.</description><identifier>ISSN: 0031-4005</identifier><identifier>ISSN: 1098-4275</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2024-065905</identifier><identifier>PMID: 39005106</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Birth weight ; Cardiac Catheterization - methods ; Cardiac Surgical Procedures - methods ; Ductus Arteriosus, Patent - surgery ; Female ; Gestational age ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Infants ; Length of Stay ; Low birth weight ; Male ; Neonates ; Septal Occluder Device ; Survival ; Treatment Outcome</subject><ispartof>Pediatrics (Evanston), 2024-08, Vol.154 (2), p.1</ispartof><rights>Copyright © 2024 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Aug 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c210t-1ce9ebe991e461af87a351d9b40384677bc5b5310ac9bf1936faef36c08727513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39005106$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leahy, Brianna F</creatorcontrib><creatorcontrib>Edwards, Erika M</creatorcontrib><creatorcontrib>Ehret, Danielle E Y</creatorcontrib><creatorcontrib>Soll, Roger F</creatorcontrib><creatorcontrib>Yeager, Scott B</creatorcontrib><creatorcontrib>Flyer, Jonathan N</creatorcontrib><title>Transcatheter and Surgical Ductus Arteriosus Closure in Very Low Birth Weight Infants: 2018-2022</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>The optimal patent ductus arteriosus (PDA) closure method in very low birth weight (VLBW) infants is uncertain. In 2019, the first transcatheter occlusion device was approved in the United States for infants ≥700 g. We described survival and short-term outcomes among VLBW infants who underwent transcatheter or surgical PDA closure (2018-2022).
Vermont Oxford Network members submitted data on infants born from 401 to 1500 g or 22 to 29 weeks' gestational age. Adjusted risk ratios (aRR) for survival, length of stay (LOS), prematurity complications, and discharge support were used to compare transcatheter versus surgical closure. Subgroup analyses were conducted for infants with birth weight ≥700 g and born in 2020-2022.
Overall, 6410 of 216 267 infants at 726 hospitals received invasive PDA treatment. Transcatheter closure increased from 29.8% in 2018 to 71.7% in 2022. VLBW infants undergoing transcatheter closure had higher survival (adjusted rate ratio [aRR] 1.03; 1.02-1.04) with similar LOS (aRR 1.00; 0.97-1.03), neonatal complications (aRR 1.00; 0.98-1.01), and receipt of discharge support (aRR 0.94; 0.89-1.01). In subgroup analyses, survival (aRR 1.02; 1.00-1.04) and discharge support (aRR 0.90; 0.81-1.01) were similar between groups, whereas selected neonatal complications (aRR 0.95; 0.93-0.98) and LOS (aRR 0.95; 0.90-0.99) were lower after transcatheter closure.
Transcatheter PDA closure in VLBW infants was increasingly used after 2018. Selected short-term outcomes for infants receiving transcatheter closure may be more favorable, compared with surgical, and warrants further clinical investigation.</description><subject>Birth weight</subject><subject>Cardiac Catheterization - methods</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Ductus Arteriosus, Patent - surgery</subject><subject>Female</subject><subject>Gestational age</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Very Low Birth Weight</subject><subject>Infants</subject><subject>Length of Stay</subject><subject>Low birth weight</subject><subject>Male</subject><subject>Neonates</subject><subject>Septal Occluder Device</subject><subject>Survival</subject><subject>Treatment Outcome</subject><issn>0031-4005</issn><issn>1098-4275</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkDtPwzAQgC0EoqWwMyFLLCwpZztOYrZSXpUqMVBgDI5zaVOlSbETof57HBUYmM7yfff6CDlnMGYy5NdbzN2YAw8DiKQCeUCGDFQShDyWh2QIIFgQAsgBOXFuDQChjPkxGQjlPxlEQ_KxsLp2RrcrbNFSXef0pbPL0uiK3nWm7RydWJ8pG-ef08oHi7Ss6RvaHZ03X_S2tO2KvmO5XLV0Vhe6bt0N5cCSwG_GT8lRoSuHZz9xRF4f7hfTp2D-_DibTuaB4QzagBlUmKFSDMOI6SKJtZAsV1kIIgmjOM6MzKRgoI3KCqZEVGgsRGQgif2xTIzI1b7v1jafHbo23ZTOYFXpGpvOpQISiISIeY9e_kPXTWdrv52nFAfh58Segj1lbOOcxSLd2nKj7S5lkPb2095-2ttP9_Z9ycVP4y7bYP5X8KtbfAOQ3X3z</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Leahy, Brianna F</creator><creator>Edwards, Erika M</creator><creator>Ehret, Danielle E Y</creator><creator>Soll, Roger F</creator><creator>Yeager, Scott B</creator><creator>Flyer, Jonathan N</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20240801</creationdate><title>Transcatheter and Surgical Ductus Arteriosus Closure in Very Low Birth Weight Infants: 2018-2022</title><author>Leahy, Brianna F ; Edwards, Erika M ; Ehret, Danielle E Y ; Soll, Roger F ; Yeager, Scott B ; Flyer, Jonathan N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c210t-1ce9ebe991e461af87a351d9b40384677bc5b5310ac9bf1936faef36c08727513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Birth weight</topic><topic>Cardiac Catheterization - methods</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Ductus Arteriosus, Patent - surgery</topic><topic>Female</topic><topic>Gestational age</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Very Low Birth Weight</topic><topic>Infants</topic><topic>Length of Stay</topic><topic>Low birth weight</topic><topic>Male</topic><topic>Neonates</topic><topic>Septal Occluder Device</topic><topic>Survival</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leahy, Brianna F</creatorcontrib><creatorcontrib>Edwards, Erika M</creatorcontrib><creatorcontrib>Ehret, Danielle E Y</creatorcontrib><creatorcontrib>Soll, Roger F</creatorcontrib><creatorcontrib>Yeager, Scott B</creatorcontrib><creatorcontrib>Flyer, Jonathan N</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leahy, Brianna F</au><au>Edwards, Erika M</au><au>Ehret, Danielle E Y</au><au>Soll, Roger F</au><au>Yeager, Scott B</au><au>Flyer, Jonathan N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcatheter and Surgical Ductus Arteriosus Closure in Very Low Birth Weight Infants: 2018-2022</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>154</volume><issue>2</issue><spage>1</spage><pages>1-</pages><issn>0031-4005</issn><issn>1098-4275</issn><eissn>1098-4275</eissn><abstract>The optimal patent ductus arteriosus (PDA) closure method in very low birth weight (VLBW) infants is uncertain. In 2019, the first transcatheter occlusion device was approved in the United States for infants ≥700 g. We described survival and short-term outcomes among VLBW infants who underwent transcatheter or surgical PDA closure (2018-2022).
Vermont Oxford Network members submitted data on infants born from 401 to 1500 g or 22 to 29 weeks' gestational age. Adjusted risk ratios (aRR) for survival, length of stay (LOS), prematurity complications, and discharge support were used to compare transcatheter versus surgical closure. Subgroup analyses were conducted for infants with birth weight ≥700 g and born in 2020-2022.
Overall, 6410 of 216 267 infants at 726 hospitals received invasive PDA treatment. Transcatheter closure increased from 29.8% in 2018 to 71.7% in 2022. VLBW infants undergoing transcatheter closure had higher survival (adjusted rate ratio [aRR] 1.03; 1.02-1.04) with similar LOS (aRR 1.00; 0.97-1.03), neonatal complications (aRR 1.00; 0.98-1.01), and receipt of discharge support (aRR 0.94; 0.89-1.01). In subgroup analyses, survival (aRR 1.02; 1.00-1.04) and discharge support (aRR 0.90; 0.81-1.01) were similar between groups, whereas selected neonatal complications (aRR 0.95; 0.93-0.98) and LOS (aRR 0.95; 0.90-0.99) were lower after transcatheter closure.
Transcatheter PDA closure in VLBW infants was increasingly used after 2018. Selected short-term outcomes for infants receiving transcatheter closure may be more favorable, compared with surgical, and warrants further clinical investigation.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>39005106</pmid><doi>10.1542/peds.2024-065905</doi></addata></record> |
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| subjects | Birth weight Cardiac Catheterization - methods Cardiac Surgical Procedures - methods Ductus Arteriosus, Patent - surgery Female Gestational age Humans Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Infants Length of Stay Low birth weight Male Neonates Septal Occluder Device Survival Treatment Outcome |
| title | Transcatheter and Surgical Ductus Arteriosus Closure in Very Low Birth Weight Infants: 2018-2022 |
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