ATLANTA (May 12, 2022) – A Children’s Healthcare of Atlanta team recently performed an effective heart vessel closure known as Patent Ductus Arteriosus (PDA) using a catheter-delivered device on a 1-pound, 1-ounce infant. Children’s cardiologist, Dr. Allen Ligon, completed a successful transcatheter PDA closure in a premature infant weighing 510 grams or 1.1 pounds. The Cardiac Cath Lab team performed the procedure by accessing a vein in the baby’s leg, then navigating the catheter and PDA closure device up through the heart inside the PDA. The device was then carefully placed within the PDA to create a controlled clot and effectively close the vessel. Six days following the procedure, the baby had gained 135 grams, was off blood pressure support meds, and weaned down significantly on respiratory ventilator support. She was transferred back to the referring Neonatal Intensive Care Unit (NICU) at Northeast Georgia Medical Center.
The ability to perform a transcatheter PDA closure in such a premature infant is still new. In fact, the device doctors used was only approved by the FDA for use as of January 2019. As the child grows, their tissue will grow over the PDA closure device and will simply become part of their body, so it will never need to be removed or changed.
“This is a true team effort, starting with the NICU staff who medically stabilized the child for the procedure; the Cath lab crew who prepared the room and performed excellent protocol execution; the anesthesiology team who provided excellent transfer as well as anesthetic care; and the imaging staff who supported us throughout this case,” said Dr. Ligon. “This new program allows for surrounding hospitals to transfer to Children’s for the procedure, and in the long run, assist in saving the lives of extremely premature babies.”
The Transcatheter Closure of Patent Ductus Arteriosus (PDA) in Infants Program at Children’s leverages expertise from neonatology, cardiology and interventional cardiology teams to provide non-surgical options for premature babies who are adversely affected by a hemodynamically-significant PDA. Patients are referred to Children’s from neonatal intensive care units (NICUs) throughout the state of Georgia. This multidisciplinary program and team are dedicated to preemie or neonatal transcatheter device closures. They review patient data and organize transfer into the hospital, complete the procedure and then expedite transfer back to the referring NICU closest to the family. Children’s is the only cardiac program in Georgia providing this less-invasive, catheter-based therapy with implantable devices in extremely premature babies as small as one pound.
The ductus arteriosus is a naturally occurring connection or vessel between the two large vessels coming from the heart – the aorta and pulmonary artery. A ductus arteriosus is normally present in all babies when they are inside the womb. It provides a pathway for blood to be diverted away from the lungs, which are not being used to provide oxygen to the blood before birth. Once a baby is born and the lungs are being used, the ductus arteriosus should shrink and close on its own. For many premature babies, the ductus arteriosus does not completely close after birth, which can lead to several medical issues including harm to the developing lungs, high pressures in the lung vessels and symptoms of congestive heart failure. When the ductus arteriosus does not completely close on its own, it’s called patent (or persistent) ductus arteriosus, or PDA.
The Children’s Heart Center is one of the largest cardiac programs in the Southeast, one of the top five largest pediatric heart centers in the nation for Cardiac Intensive Care Unit (CICU) and Cardiac Acute Care Unit (CACU) volumes, and one of the top ten largest pediatric heart centers for heart surgery, catheterization procedure and transplant volumes.