Feasibility and Success of Muscular Ventricular Septal Defect Occluders and Mushroom-Shaped Occluders in Transcatheter Patent Ductus Arteriosus Closure in Low-Weight Children: A Propensity Score-Matched Retrospective Analysis from a Chinese National Regional Health Center

被引：0

作者：

Zhang, Kaijun ^{[1
,2
,3
]}

Yang, Le ^{[4
]}

Zhang, Rensen ^{[2
,5
]}

Ma, Jingdong ^{[6
]}

Cheng, Min ^{[2
]}

Yang, Penghui ^{[1
,2
,3
]}

Xiang, Ping ^{[1
,2
,3
,7
]}

Li, Mi ^{[1
,2
,3
]}

Zhou, Xue ^{[1
,2
,3
]}

机构：

[1] Chongqing Med Univ, Childrens Hosp, Dept Cardiovasc Med, Chongqing, Peoples R China

[2] Chongqing Municipal Hlth Commiss, Key Lab Child Dev & Disorders, Natl Clin Res Ctr Child Hlth & Disorders, Chongqing Key Lab Pediat,Key Lab Childrens Importa, Chongqing, Peoples R China

[3] Natl Clin Key Cardiovasc Specialty, Chongqing, Peoples R China

[4] Chengdu Med Coll, Chengdu Seventh Peoples Hosp, Affiliated Canc Hosp, Dept Pediat, Chengdu, Peoples R China

[5] Chongqing Med Univ, Childrens Hosp, Dept Gen Surg, Chongqing, Peoples R China

[6] Chongqing Med Univ, Chongqing, Peoples R China

[7] Chongqing Med Univ, Childrens Hosp, Dept Neurol, Chongqing, Peoples R China

来源：

CARDIOLOGY | 2024年

关键词：

Transcatheter; Muscular ventricular septal defect occluder; Mushroom-shaped occluder; Patent ductus arteriosus; Outcomes; OFF-LABEL USE; 6; KG; INFANTS; OCCLUSION;

D O I：

10.1159/000540685

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Muscular ventricular septal defect occluders (MVSDOs) have been attempted as an option in low-weight patients with patent ductus arteriosus (PDA). However, few studies have assessed the safety of transcatheter patent ductus arteriosus closure (TCPC) using MVSDO. Therefore, we compared the outcomes in low-weight patients who used MVSDO and mushroom-shaped occluder (MSO). Methods: Medical records of children under 10 kg (n = 417) who underwent TCPC from 2015 to 2021 at a Chinese health center were reviewed. They were divided into MSO (n = 372) and MVSDO (n = 45) groups. A 1:1 propensity score matching (PSM) was done considering gender, height, weight, body surface area (BSA), PDA diameter, and BSA-corrected PDA diameter. Results: All 45 children in the MVSDO group (mean weight: 5.92 +/- 1.32 kg) achieved successful immediate occlusion. One case in the MVSDO group experienced device migration within 24 h requiring unplanned surgery. MVSDO significantly ameliorated pulmonary artery hypertension. After PSM, each group comprised 41 children. The MVSDO group had a smaller effect on platelet counts (MVSDO vs. MSO = 259.85 +/- 114.82 vs. 356.12 +/- 134.37, p < 0.001), a reduced incidence of thrombocytopenia (MVSDO vs. MSO = 2/41 vs. 7/41, p = 0.001), and a higher rate of residual shunting (MVSDO vs. MSO = 16/41 vs. 5/41, p = 0.005), compared with the MSO group. Thrombocytopenia resolved during hospitalization and micro-shunts disappeared by 6 months. No pulmonary artery or descending aortic secondary stenosis was observed in 1-year follow-up. Conclusions: MVSDO used in low-weight children is feasible, with high success and satisfactory postoperative and short-term follow-up outcomes, including lower thrombocytopenia incidence, compared to MSO. Further long-term studies with larger samples are recommended.

引用

页码：212 / 220

页数：9