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Immediate and Long-Term Results of Transcatheter Closure of Patent Ductus Arteriosus—Comparison of Two Decades before and after Change in Antibiotic Infective Endocarditis Prophylaxis Guidelines

Annina Dietrich1,2, Daniel Quandt1,2, Oliver Kretschmar1,2, Walter Knirsch1,2,*

1 Pediatric Cardiology, Pediatric Heart Center, Department of Surgery and Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
2 University of Zurich, Zurich, Switzerland

* Corresponding Author: Walter Knirsch. Email: email

Congenital Heart Disease 2022, 17(2), 215-230. https://doi.org/10.32604/CHD.2021.017232

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 D (2.1%), elongated type E (0.9%) and other (5.4%). Minimal PDA diameter and length were 1.9 mm (1.3–2.5) and 8.0 mm (6.2–10.2). PDA was closed using coils (56.3%), Amplatzer Duct Occluders (41.9%) and others (1.8%). Complete closure rate was 61.1% at catheter intervention, 72.3% on day 1, 87.7% after 6 months and 98.4% at last follow-up on echocardiography. Moderate complication rate (severity level 3) was 4.2% and major complication rate (severity level 4) 0.3%, with no catastrophic complications (severity level 5). Annual PDA closure rate declined in the second time period (22.6/year vs. 15.5/ year, p = 0.018), PDA size increased (1.6 mm vs. 2.0 mm, p = 0.002) and proportion of coils decreased (72.4% vs. 37.1%, p < 0.001). Conclusions: Interventional closure of PDA is associated with excellent closure rates during follow-up (>98%) and only a small number of complications leading to reintervention or surgery. Change in AP guidelines changed indication for and practice of PDA closure.

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APA Style
Dietrich, A., Quandt, D., Kretschmar, O., Knirsch, W. (2022). Immediate and long-term results of transcatheter closure of patent ductus arteriosus—comparison of two decades before and after change in antibiotic infective endocarditis prophylaxis guidelines. Congenital Heart Disease, 17(2), 215-230. https://doi.org/10.32604/CHD.2021.017232
Vancouver Style
Dietrich A, Quandt D, Kretschmar O, Knirsch W. Immediate and long-term results of transcatheter closure of patent ductus arteriosus—comparison of two decades before and after change in antibiotic infective endocarditis prophylaxis guidelines. Congeni Heart Dis. 2022;17(2):215-230 https://doi.org/10.32604/CHD.2021.017232
IEEE Style
A. Dietrich, D. Quandt, O. Kretschmar, and W. Knirsch "Immediate and Long-Term Results of Transcatheter Closure of Patent Ductus Arteriosus—Comparison of Two Decades before and after Change in Antibiotic Infective Endocarditis Prophylaxis Guidelines," Congeni. Heart Dis., vol. 17, no. 2, pp. 215-230. 2022. https://doi.org/10.32604/CHD.2021.017232



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