Use of the Medtronic Microvascular Plug 7Q for transcatheter closure of large patent ductus arteriosus in infants weighing less than 2.5 kg. Issue 5 (30th January 2022)

• Record Type: Journal Article
• Authors: Nasef, Mohamed Al; O'Sullivan, Donnchadh; Ng, Li Yen; Walsh, Kevin P.; Oslizlok, Paul; McCrossan, Brian; Kenny, Damien; Sathanandam, Shyam
• Is Part Of: Catheterization and cardiovascular interventions. Volume 99:Issue 5(2022)
• Page Start: 1545
• Page End: 1550
• Publication Date: 2022-01-30
• Subjects: coil/device/transcatheter -- congenital heart disease -- embolization -- endovascular -- intervention -- pediatrics; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.30105
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Background: The sole Food and Drug Administration‐approved device for transcatheter closure of the patent arterial duct in premature infants is indicated for patent ductus arteriosus (PDAs) ≤ 4 mm in diameter. We report a two‐center experience with transcatheter closure of large PDAs (>4 mm) in infants weighing <2.5 kg using the Microvascular Plug 7Q (MVP‐7Q) device. Methods: This is a retrospective review of departmental databases and medical charts to define patient cohort and report demographic, procedural, and follow‐up data. Results: Twenty‐two patients (12 male) with a median gestational age and birthweight of 25.5 weeks (interquartile range [IQR] = 24–28) and 800 g (572–1075), respectively, underwent attempted PDA occlusion with the MVP‐7Q using a transvenous approach. The median age and weight at the time of PDA occlusion was 32 days (IQR = 24–28) and 1100 g (IQR = 960–1700), respectively. The median PDA length was 12 mm (IQR = 11–12.65). The median PDA diameters at the aortic and pulmonary ends were 5.1 (IQR = 4.9–5.5) and 4.8 mm (IQR = 4.6–5.3), respectively. Successful device occlusion was achieved in 20 patients (91%). There were two failed attempts: One due to inappropriate sizing, and the other secondary to left pulmonary artery stenosis. There were no procedural complications and no residual shunting on follow‐up. Conclusions: The MVP‐7Q is safe and effective for transcatheter closure of large (>4 mm) PDAs in infants <2.5 kg. The lack of retention disks may help with avoiding impingement on surrounding vessels.