Background
Transcatheter PDA closure (TCPC) in VLBW infants using the Piccolo (P) device & the Microvascular Plug (MVP) has been reported.
Methods
VLBW (1600 ≤ gm) infants who underwent TCPC at our center from 5/18 to 12/20 were included. Pt profile, PDA anatomy, cath lab data & early outcomes using the MVP (group 1) & the Piccolo occlude (group 2) were compared.
Results
45 VLBW infants underwent TCPC during the study period (MVP-19, P -26). Pt profile, PDA anatomy & cath lab data is shown in table 1. Comparing the 2 groups, median gestational age, birth wt, procedure wt & age, PDA anatomy procedure & fluoroscopy time, DAP & contrast used were comparable. In both groups, the vast majority of PDA morphology were type C/F & device diameters used ranged 3-5mm.
Device repositioning was needed in 9/19 (47%) in group 1 & 12/26 (46%) in group 2.
Successful implant was achieved in 19/19 (100%) in group 1 & 24/26 (92%) in group 2. There were no major complications in both groups.
Embolizations (2) occurred in group 2 and were retrieved.
Other minor complications were similar for both groups (MVP-4, P-5) and included mild LPA flow acceleration (3) for both groups, mild aortic obstruction (1) in group 1 & mild-moderate tricuspid regurgitation (TR) (2) in group 2.
Conclusions
The MVP & Piccolo devices can be implanted in PDAs of VLBW infants with equal effectiveness. Repositioning of both devices are commonly required. In spite of greater radiolucency of the MVP & the extra catheter exchange for the Piccolo, procedural & flouroscopy time, DAP & contrast used were similar.
No major complications were encountered. Minor complications were common for both devices, especially minor LPA obstruction & TR.