B-6 | Timing of Transcatheter Device Closure of Patent Ductus Arteriosus in Premature Infants: Does Weight Matter?

Device closure of patent ductus arteriosus in premature infants has been demonstrated to be safe and effective. PDA closure in patients weighing 2-5 kg represents a unique challenge because intraductal deployment carries risk of embolization, and standard deployment carries risk of aortic and/or pulmonary obstruction. Impact of weight at procedure has rarely been reported. Retrospective review of device closure of PDA in premature infants (GA <37) under 5 kg between 2009 and 2023. A total of 70 patients were identified, one patient found to have no access, was excluded. Table 1 summarizes the results. In the 2-5kg group, eight patients with unsuccessful attempts were due to duct being too large, too short or having inadequate aortic ampulla for safe device placement. The five unsuccessful attempts in the <2kg group were either too small to cross, or too large/short for safe device deployment. In terms of complications, there was no procedural mortality in either group. Two patients in the 2-5kg group required heparin infusion post procedure for weak or absent pulses, both resolved in the first 24 hours. And another patient developed device related LPA stenosis requiring stenting at follow up. In the <2kg group, one patient had moderate TR that resolved at follow up with no intervention. Median follow up was 5.6 months (<2kg) and 6.1 months (2-5kg). Weight did not significantly impact immediate and short-term outcomes of preemie PDA closure. Though not statistically significant, patients <2kg had shorter Fluoroscopy time. This should support early referral for device closure.