2025/11/27 by Malekzadeh-Milani, Sophie, Padovani, Paul, Sivakumar, Kothandam +28
Medicine · #610 Medicine & #Bajo peso al nacer #Cardiac catheterization #Cardiopatía congénita #Cardiovascular Conditions and Treatments #Cateterismo cardiaco #Congenital Heart Disease Studies #Congenital heart disease #Ductus arterioso #Ductus arteriosus #Ear Surgery and Otitis Media #Infant #Keywords: Congenital heart disease Cardiac catheterization Infant Low birth weight Ductus arteriosus Patent #Lactante #Low birth weight #Patent #Persistente #health
paper · doi:10.5167/uzh-280862
openalex publication_date 2025/11/27 · openalex created_date 2025/12/11 · openalex updated_date 2026/07/28
Introduction and objectives: Transcatheter patent ductus arteriosus (PDA) closure is safe in < 2-kg infants and in ≥ 6-kg patients, but major safety concerns remain when applied to the intermediate weight range. We aimed to assess outcomes of transcatheter PDA closure in 2- to 6-kg infants. Methods: An international, multicenter, retrospective cohort study was conducted in 31 tertiary hospitals in 17 countries between 2000 and 2023, investigating all infants who underwent attempted transcatheter PDA closure with a procedural weight of 2-to-6kg. Results: Attempted transcatheter PDA closure was performed in 1231 infants (median [Q1-Q3] weight, 4747 [3700-5300] g; median age, 132 [83-194] days; ex-preterm, n=581 [56.8%]) with a 95.0% success rate. A composite outcome of procedural failure or major adverse events was observed in 173 (14%) patients, including device embolization in 64 (3.7%), device-induced left pulmonary artery stenosis in 47 (2.7%), and procedural death in 2 (0.2%). Logistic regression model analysis identified a 2- to 3.9-kg procedural weight, increased pulmonary artery pressure, and window-type or tubular ductal morphologies as independent predictors of the composite outcome. Based on propensity score matching analysis, 2- to 3.9-kg infants had a risk ratio of 2.19 (95%CI, 1.25-3.83) for experiencing the composite outcome, compared with 4- to 5.9-kg infants. Conclusions: Transcatheter PDA closure in 2- to 6-kg infants was feasible in most patients. Procedural failure or major adverse events occurred in 14% and several independent risk factors were identified, including the 2- to 3.9-kg weight range identified as a higher-risk subgroup. These findings may improve risk stratification and the decision-making process.