207 - Feasibility, Safety, and Short-Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High Frequency Jet Ventilation

Poster Number: 207
Publication Number: 207.220

Kamel Shibbani, University of Iowa Stead Family Children's Hospital, Iowa City, IA, United States; Daniel McLennan, Medical College of Wisconsin, Milwaukee, WI, United States; Adrianne Rahde Bischoff, University of Iowa, Iowa city, IA, United States; Patrick J. McNamara, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, United States; Jonathan M. Klein, University of Iowa Stead Family Children's Hospita, Iowa City, IA, United States; Regan E. Giesinger, University of Iowa, Iowa City, IA, United States; Osamah Aldoss, University of Iowa, Iowa city, IA, United States

Background: Prolonged exposure to a hemodynamically significant Patent Ductus Arteriosus (PDA) is associated with major morbidity, particularly in infants born less than 27 week’s gestation. High Frequency Jet Ventilation (HFJV) is a standard of care at our center to minimize barotrauma and promote alveologenesis. There is no data related to the feasibility, safety, and outcomes of HFJV as the primary strategy during transcatheter PDA closure.

Objective: To assess the feasibility, safety, and outcomes of HFJV as the primary strategy during transcatheter PDA closure.

Design/Methods: This is a retrospective cohort study of premature infants undergoing transcatheter device closure while on HFJV. The primary outcome was successful device placement. Secondary outcomes included procedure time, fluoroscopy time and dose, time off unit, device complications, need for escalation in respiratory support, and 7-day survival. Subgroup comparative evaluation of patients managed with HFJV vs a small cohort of patients managed with conventional mechanical ventilation was performed.

Results: 38 patients were included in the study. Median age and median weight at PDA device closure for HFJV cohort were 32 days (IQR 25.25-42.0 days) and 1115 grams (IQR 885-1310 grams) respectively. There was successful device placement in 100% of patients. There were no device complications noted.
The time off-unit and the procedure time were not significantly different between the HFJV group and the conventional ventilation group. Infants managed by HFJV had shorter fluoroscopy times (4.7 vs 7.0 min, U=64, p < 0.05) and no increased risk of adverse respiratory outcomes.Conclusion(s): Transcatheter PDA closure in premature babies on HFJV is a safe and effective approach that does not compromise device placement success rate and does not lead to secondary complications.
DemographicsTable highlighting the demographic data of the entire population and showing the differences between the HFJV group and the CMV group.
Metrics of cardiac catheterization for HFJV vs CMVComparison of cardiac catheterization metrics between the HFJV group and the CMV group. Only the fluoroscopy time was significantly different between the time, with the HFJV group have shorter fluoroscopy times.