Placement of Ductus Arteriosus Stent in Children With Ductal Dependent Pulmonary Blood Flow - Single Center Experience

Aim: To evaluate the efficacy and safety of transcatheter patent ductus arteriosus (PDA) stenting in neonates with ductal dependent pulmonary blood flow (DD-PBF). Methods: This retrospective cohort study was performed in patients with DD-PBF and PDA stenting from July 2020 to March 2023. Demographics, prior treatments, diagnoses, PDA-related information, intervention (stenting) data, and outcomes were recorded. Re-interventions and mortality data were also assessed. Results: The median age of the patients was 8 (1 - 100) days; 25 were females and 15 were males. Oxygen saturation increased significantly after index PDA stenting (p<0.001). Complication rate was 15%. Complications included ventricular fibrillation in one patient, complete AV block in one patient, short-term SVT in one patient, stent embolization in one patient, pseudoaneurysm in one patient, and floppy wire stuck in one patient. During follow-up, no patient died due to stent-related complications. Median length of intensive care unit stay was 8 days after the procedures. Re-intervention was required in 6 (15.00%) patients during follow-up. Median re-intervention time was 95 (48 - 232) days. Surgical repair was performed in 24 patients at a median of 83 (12-344) days. Stent placement at younger age, atypical PDA type and elongated PDA were associated with higher likelihood of re-intervention. Conclusion: PDA stenting is an efficient and safe primary palliative intervention with manageable complication rates among children reliant on DD-PBF. There appears to be higher risks for re-intervention among younger children and those with elongated or atypical PDAs.