PMID- 33098843
OWN - NLM
STAT- MEDLINE
DCOM- 20210429
LR  - 20210429
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Linking)
VI  - 230
DP  - 2021 Mar
TI  - Percutaneous Closure of Patent Ductus Arteriosus in Infants 1.5 kg or Less: A 
      Meta-Analysis.
PG  - 84-92.e14
LID - S0022-3476(20)31307-X [pii]
LID - 10.1016/j.jpeds.2020.10.035 [doi]
AB  - OBJECTIVE: To investigate technical success and safety of percutaneous patent 
      ductus arteriosus closure in infants </=1.5 kg. STUDY DESIGN: A systematic review 
      and meta-analysis was performed. Data sources included Scopus, Web of Science, 
      Embase, CINAHL, Cochrane, and PubMed from inception to April 2020. Publications 
      were included if they had a clear definition of the intervention as percutaneous 
      patent ductus arteriosus closure in infants </=1.5 kg. Data extraction was 
      independently performed by multiple observers. Primary outcome was technical 
      success and secondary outcomes were adverse events (AEs). Subgroup analysis was 
      performed in infants </=6.0 kg. Data were pooled by using a random-effects model. 
      RESULTS: We included 28 studies, including 373 infants </=1.5 kg and 69 studies 
      enrolling 1794 infants </=6.0 kg. In patients </=1.5 kg, technical success was 96% 
      (95% CI, 93%-98%; P = .16; I(2) = 23%). The overall incidence of AE was 27% (95% 
      CI, 17%-38%; P < .001; I(2) = 70%) and major AEs was 8% (95% CI, 5%-10%; P = .63; 
      I(2) = 0%). There were 5 deaths related to the procedure (2%; 95% CI, 1%-4%; 
      P = .99; I(2) = 0%); 4 of these deaths occurred in infants <0.8 kg. The 
      probability of technical failure was inversely related to age at the time of the 
      procedure (OR, 0.9; 95% CI, 0.830-0.974; P = .009). Weight at intervention has 
      decreased over time and procedural success has increased. CONCLUSIONS: 
      Percutaneous patent ductus arteriosus closure is feasible in infants </=1.5 kg with 
      few major AEs. The procedural success rate is high, despite performing the 
      intervention in smaller patients. PROSPERO REGISTRATION: CRD42020145230.
CI  - Crown Copyright (c) 2020. Published by Elsevier Inc. All rights reserved.
FAU - Bischoff, Adrianne Rahde
AU  - Bischoff AR
AD  - Department of Pediatrics, University of Iowa, Iowa City, IA.
FAU - Jasani, Bonny
AU  - Jasani B
AD  - Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, 
      Canada.
FAU - Sathanandam, Shyam K
AU  - Sathanandam SK
AD  - Department of Pediatrics, University of Tennessee Health Science Center, Memphis, 
      TN.
FAU - Backes, Carl
AU  - Backes C
AD  - Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.
FAU - Weisz, Dany E
AU  - Weisz DE
AD  - Newborn and Developmental Pediatrics, Sunnybrook Health Sciences Center, Toronto, 
      Ontario, Canada.
FAU - McNamara, Patrick J
AU  - McNamara PJ
AD  - Department of Pediatrics, University of Iowa, Iowa City, IA; Department of 
      Internal Medicine, University of Iowa, Iowa City, IA. Electronic address: 
      patrick-mcnamara@uiowa.edu.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20201022
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
SB  - IM
MH  - Cardiac Catheterization/adverse effects/*methods/mortality
MH  - Ductus Arteriosus, Patent/*therapy
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Infant, Premature
MH  - Infant, Very Low Birth Weight
MH  - Treatment Outcome
OTO - NOTNLM
OT  - adverse outcomes
OT  - catheter
OT  - patent ductus arteriosus
OT  - percutaneous
OT  - technical success
OT  - transcatheter
EDAT- 2020/10/26 06:00
MHDA- 2021/04/30 06:00
CRDT- 2020/10/25 00:00
PHST- 2020/08/25 00:00 [received]
PHST- 2020/10/15 00:00 [revised]
PHST- 2020/10/16 00:00 [accepted]
PHST- 2020/10/26 06:00 [pubmed]
PHST- 2021/04/30 06:00 [medline]
PHST- 2020/10/25 00:00 [entrez]
AID - S0022-3476(20)31307-X [pii]
AID - 10.1016/j.jpeds.2020.10.035 [doi]
PST - ppublish
SO  - J Pediatr. 2021 Mar;230:84-92.e14. doi: 10.1016/j.jpeds.2020.10.035. Epub 2020 
      Oct 22.