Clinical efficacy analysis of different interventional approaches for patent ductus arteriosus in children (≤7 years)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Zeming ¹ , WANG Hongmao ² ,  ZHENG Hong ¹ , SONG Huijun ¹ , LI Shiguo ¹ , YAN Chaowu ¹ , HU Haibo ¹ , LIU Qiong ¹ , XU Zhongying ¹ , XU Liang ¹ , LV Jianhua ¹ , ZHANG Gejun ¹ , WAN Junyi ¹ , JIN Jinglin ¹

1. Department of Structural Heart Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, P. R. China;
2. Department of Cardiovascular Diseases, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, 100020, P. R. China;

Corresponding author：

ZHENG Hong, Email: zheng_hung@126.com

Keywords：

Patent ductus arteriosus; interventional closure; conventional arteriovenous approach; simple venous approach; retrograde femoral artery approach

DOI：

10.7507/1007-4848.202104002

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Objective To explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children.Methods The children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications.Conclusion It is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.

Citation： ZHOU Zeming, WANG Hongmao, ZHENG Hong, SONG Huijun, LI Shiguo, YAN Chaowu, HU Haibo, LIU Qiong, XU Zhongying, XU Liang, LV Jianhua, ZHANG Gejun, WAN Junyi, JIN Jinglin. Clinical efficacy analysis of different interventional approaches for patent ductus arteriosus in children (≤7 years). Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(5): 699-703. doi: 10.7507/1007-4848.202104002 Copy

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2.	Porstmann W, Wierny L, Warnke H. Closure of persistent ductus arteriosus without thoracotomy. Ger Med Mon, 1967, 12(6): 259-261.
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4.	Djer MM, Saputro DD, Putra ST, et al. Transcatheter closure of patent ductus arteriosus: 11 years of clinical experience in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Pediatr Cardiol, 2015, 36(5): 1070-1074.
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6.	Baruteau AE, Hascoët S, Baruteau J, et al. Transcatheter closure of patent ductus arteriosus: Past, present and future. Arch Cardiovasc Dis, 2014, 107(2): 122-132.
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9.	周冀玮, 易岂建, 王献民. 儿童动脉导管未闭介入治疗单中心疗效及中长期随访观察. 临床儿科杂志, 2020, 38(4): 275-280.
10.	孟祥春, 蔡华波, 李志川, 等. 动脉导管造影联合经胸超声在动脉导管未闭封堵术治疗中的应用. 中国当代儿科杂志, 2010, 12(2): 103-105.
11.	王震, 高磊, 解启莲, 等. 经导管单纯静脉途径封堵动脉导管未闭. 临床荟萃, 2007, 22(14): 1025-1026.
12.	张伟华, 田民, 雷芸, 等. 两种单静脉法与传统 Amplatzer 法治疗动脉导管未闭. 中国介入影像与治疗学, 2007, 4(2): 101-105.
13.	罗国新, 何建新, 龚志华. 单纯股静脉入路封堵治疗儿童动脉导管未闭. 广东医学, 2014, (16): 2579-2580.
14.	Wilson WM, Shah A, Osten MD, et al. Clinical outcomes after percutaneous patent ductus arteriosus closure in adults. Can J Cardiol, 2020, 36(6): 837-843.
15.	Gruenstein DH, Ebeid M, Radtke W, et al. Transcatheter closure of patent ductus arteriosus using the AMPLATZER™ duct occluder Ⅱ (ADO Ⅱ). Catheter Cardiovasc Interv, 2017, 89(6): 1118-1128.
16.	Morgan G, Tometzki AJ, Martin RP. Transcatheter closure of long tubular patent arterial ducts: The AMPLATZER duct occluder Ⅱ-A new and valuable tool. Catheter Cardiovasc Interv, 2009, 73(4): 576-580.
17.	张戈军, 徐仲英, 蒋世良, 等. 第二代 Amplatzer 动脉导管未闭封堵器经股动脉逆行插管行室间隔缺损封堵术疗效评价. 临床荟萃, 2015, 30(6): 601-604.

1. Schneider DJ, Moore JW. Patent ductus arteriosus. Circulation, 2006, 114(17): 1873-1882.
2. Porstmann W, Wierny L, Warnke H. Closure of persistent ductus arteriosus without thoracotomy. Ger Med Mon, 1967, 12(6): 259-261.
3. Choi DY, Kim NY, Jung MJ, et al. The results of transcatheter occlusion of patent ductus arteriosus: Success rate and complications over 12 years in a single center. Korean Circ J, 2010, 40(5): 230-234.
4. Djer MM, Saputro DD, Putra ST, et al. Transcatheter closure of patent ductus arteriosus: 11 years of clinical experience in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Pediatr Cardiol, 2015, 36(5): 1070-1074.
5. Jin M, Liang YM, Wang XF, et al. A retrospective study of 1, 526 cases of transcatheter occlusion of patent ductus arteriosus. Chin Med J (Engl), 2015, 128(17): 2284-2289.
6. Baruteau AE, Hascoët S, Baruteau J, et al. Transcatheter closure of patent ductus arteriosus: Past, present and future. Arch Cardiovasc Dis, 2014, 107(2): 122-132.
7. Liu J, Gao L, Tan HL, et al. Transcatheter closure through single venous approach for young children with patent ductus arteriosus: A retrospective study of 686 cases. Medicine (Baltimore), 2018, 97(35): e11958.
8. 王炎. 超声心动图估测动脉导管未闭内径可靠性的评估. 四川大学, 2007.
9. 周冀玮, 易岂建, 王献民. 儿童动脉导管未闭介入治疗单中心疗效及中长期随访观察. 临床儿科杂志, 2020, 38(4): 275-280.
10. 孟祥春, 蔡华波, 李志川, 等. 动脉导管造影联合经胸超声在动脉导管未闭封堵术治疗中的应用. 中国当代儿科杂志, 2010, 12(2): 103-105.
11. 王震, 高磊, 解启莲, 等. 经导管单纯静脉途径封堵动脉导管未闭. 临床荟萃, 2007, 22(14): 1025-1026.
12. 张伟华, 田民, 雷芸, 等. 两种单静脉法与传统 Amplatzer 法治疗动脉导管未闭. 中国介入影像与治疗学, 2007, 4(2): 101-105.
13. 罗国新, 何建新, 龚志华. 单纯股静脉入路封堵治疗儿童动脉导管未闭. 广东医学, 2014, (16): 2579-2580.
14. Wilson WM, Shah A, Osten MD, et al. Clinical outcomes after percutaneous patent ductus arteriosus closure in adults. Can J Cardiol, 2020, 36(6): 837-843.
15. Gruenstein DH, Ebeid M, Radtke W, et al. Transcatheter closure of patent ductus arteriosus using the AMPLATZER™ duct occluder Ⅱ (ADO Ⅱ). Catheter Cardiovasc Interv, 2017, 89(6): 1118-1128.
16. Morgan G, Tometzki AJ, Martin RP. Transcatheter closure of long tubular patent arterial ducts: The AMPLATZER duct occluder Ⅱ-A new and valuable tool. Catheter Cardiovasc Interv, 2009, 73(4): 576-580.
17. 张戈军, 徐仲英, 蒋世良, 等. 第二代 Amplatzer 动脉导管未闭封堵器经股动脉逆行插管行室间隔缺损封堵术疗效评价. 临床荟萃, 2015, 30(6): 601-604.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical efficacy analysis of different interventional approaches for patent ductus arteriosus in children (≤7 years)

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