Jennifer L. Shepherd, Shahab Noori

Congenital Heart Disease, Vol.14, No.1, pp. 21-26, 2019, DOI:10.1111/chd.12727

Abstract Objective: There is no consensus on the definition of a hemodynamically significant patent ductus arteriosus (hsPDA). In this review article, our objective is to discuss the main variables that one should consider when determining the hemodynamic signifi‐ cance of a PDA.
Results: We describe the various approaches that have been utilized over time to define an hsPDA and discuss the strengths and weaknesses of each echocardio‐ graphic index. Finally, we propose a comprehensive and individualized approach in determining the hemodynamic significance of the PDA.
Conclusion: There are several PDA‐related clinical, echocardiographic, and other ob‐ jective variables to take into consideration… 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 >

Anthony Merlocco

Congenital Heart Disease, Vol.14, No.1, pp. 100-104, 2019, DOI:10.1111/chd.12719

Abstract The ductus arteriosus (DA) has been studied since Galen. Initially after birth in neo‐ nates with obstruction to pulmonary blood flow, DA patency is integral to ensure out‐ put and oxygenation. While DA stenting dates back 25 years, there is emerging interest in better understanding how and when to utilize this strategy as an alternative to surgi‐ cal shunt placement or ongoing prostaglandin administration. Understanding the nor‐ mal fetal circulation and the perturbations that affect flow and oxygenation is integral to comprehending how normal DA anatomy and morphology may change and how this may influence technical and clinical considerations. In… 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 >

Shyam Sathanandam, Ashley Gianinni, Eric Sefton, Kaitlyn Greer, Nathan Stecchi, Kimberly Allen, Ranjit Philip, B. Rush Waller

Congenital Heart Disease, Vol.14, No.1, pp. 85-89, 2019, DOI:10.1111/chd.12710

Abstract Objective: The objective of this article is to describe a live case transmission of tran‐ scatheter closure of a patent ductus arteriosus (PDA) in an extremely low birth weight (ELBW) infant during the first International PDA Symposium conducted in Memphis, Tennessee.
Setting: A multidisciplinary team approach including audiovisual specialists, informa‐ tion technology specialists, physicians, nurses, and other health care specialists was required to perform the transcatheter PDA closure (TCPC) in an ELBW infant at LeBonheur Children’s Hospital and the procedure was broadcast live to the attend‐ ees at the International PDA Symposium allowing for a two‐way audiovisual discus‐ sion during… More >

Leah Apalodimas, Benjamin Rush Waller III, Ranjit Philip, Judy Crawford, Jorden Cunningham, Shyam Sathanandam

Congenital Heart Disease, Vol.14, No.1, pp. 90-94, 2019, DOI: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… More >

Govinda Paudel, Vijaya Joshi

Congenital Heart Disease, Vol.14, No.1, pp. 42-45, 2019, DOI:10.1111/chd.12703

Abstract Management of the patent ductus arteriosus (PDA) in the premature infant has been a point of controversy for decades as smaller and earlier gestational age infants have been surviving. Increasing experience with catheter‐based device closure has gener‐ ated a new wave of interest in this subject. In this era, echocardiography plays a cen‐ tral role for collaboration within a multispecialty team. Reliability of echocardiography is improved by applying an institutionally derived standard approach to imaging, data collection, and reporting. The key aspects of both the physiology and anatomy of the PDA to distinguish infants that may benefit from intervention are… More >

Ranjit Philip¹, Jason Nathaniel Johnson^1,2, Ronak Naik¹, Dai Kimura^1,3, Umar Boston¹, Sandeep Chilakala¹, Benjamin Hendrickson¹, Benjamin Rush Waller¹, Shyam Sathanandam¹

Congenital Heart Disease, Vol.14, No.1, pp. 37-41, 2019, DOI:10.1111/chd.12702

Abstract The hemodynamic effects of a patent ductus arteriosus (PDA) are well known including systemic hypoperfusion and volume overload on the left ventricle. This article aims to provide a review of the long-standing effect of a hemodynamically significant PDA on the pulmonary vasculature and the role of cardiac catheterization in preterm infants with a PDA and pulmonary hypertension. More >

Ranjit Philip¹, Jeffrey A. Towbin¹, Shyam Sathanandam ¹, Jason Goldberg¹, Thomas Yohannan¹, Nithya Swaminathan¹, Jason Nathaniel Johnson^1,2

Congenital Heart Disease, Vol.14, No.1, pp. 33-36, 2019, DOI:10.1111/chd.12701

Abstract There continues to be controversy on the long‐term effects of a patent ductus arte‐ riosus (PDA) and its management. However, the hemodynamic effects of a large PDA in a preterm infant are well known. This article aims to provide insight into the adap‐ tive changes and remodeling effects of a PDA on the myocardium in preterm infants. More >