Impact of a Multidisciplinary Service Line and Program for Transcatheter Device Closure of the Neonatal Ductus Arteriosus

Abstract

Objective– Outline a quality initiative establishing an institutional service line for neonatal transcatheter device closure of the patent ductus arteriosus (TDC-PDA). Study Design – A retrospective descriptive observational study surrounding programmatic approach to TDC-PDA in premature neonates with process measure spanning education, implementation, referral, and post-procedural care. Metrics tracked pre- and post-program creation with statistical analyses performed. Results – Neonatal TDC-PDA referrals increased exponentially since program inception (n=13 in year prior; n=42 year 1; n=74 year 2), especially in patients weighing less than 1.3 kg (12.5%; 55%; 50%), and was associated with an increased procedural success rate (81%; 95%; 99%). Procedural checklist creation decreased procedural “out of isolette” time (median 93 minutes; 59; 52), and procedural-related complication or clinical sequelae (19%; 12%; 4%). Conclusion – A multidisciplinary service line and program dedicated to neonatal TDC-PDA can result in a significant increase in referrals as well as procedural efficacy and safety for this medically fragile population.