@Article{CHD.2021.017232,
AUTHOR = {Annina Dietrich, Daniel Quandt, Oliver Kretschmar, Walter Knirsch},
TITLE = {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},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {17},
YEAR = {2022},
NUMBER = {2},
PAGES = {215--230},
URL = {http://www.techscience.com/schd/v17n2/46679},
ISSN = {3071-1738},
ABSTRACT = {<b>Objectives:</b> To determine immediate and long-term follow-up of transcatheter closure of patent ductus arteriosus
(PDA) in children. <b>Background:</b> National antibiotic prophylaxis (AP) guideline for infective endocarditis changed after 2009, the effect on practice of PDA closure is unknown. <b>Methods:</b> 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. <b>Results: </b>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, <i>p</i> = 0.018), PDA size increased (1.6 mm <i>vs.</i> 2.0 mm, <i>p</i> = 0.002) and proportion of coils decreased (72.4% <i>vs.</i>
37.1%, <i>p</i> < 0.001). <b>Conclusions:</b> 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.},
DOI = {10.32604/CHD.2021.017232}
}