Changes in Left Ventricular Systolic Function after Transcatheter Patent Ductus Arteriosus Closure in Premature Infants

Abstract

Abstract Introduction Changes in left ventricular (LV) systolic function have not been well described in premature neonates after transcatheter patent ductus arteriosus (PDA) closure. Methods We retrospectively identified all premature neonates < 3kg who underwent transcatheter PDA closure at our center between 1/1/15 and 1/31/21. LV indices before and after closure were extracted and analysis performed. Results 23 patients were included with a mean procedural weight of 1894 ± 622 gm. At 24 hrs after closure, the median LVEF (66% IQR 12 vs. 61% IQR 12, p< 0.001) and median LV end diastolic dimension z-score (3.3 IQR 1.8 vs. 1.4 IQR 2.6, p<0.001) both decreased and 5 (22%) patients had an LVEF < 55%. Patients who had an LVEF < 55% at 24 hrs had a higher pre-procedure LV end-diastolic dimension z-score (4.2 IQR 1.2 vs 2.8 IQR 1.6, p=0.01), a higher pre-procedure LV end-diastolic volume (19 ml IQR 4 vs. 11 ml IQR 11, p=0.03), a higher birth weight (940 gm IQR 100 vs. 760 gm IQR 140, p=0.04), and were more likely to receive intravenous calcium during the procedure (60% vs. 11%, p=0.04) compared to those with an LVEF ≥ 55% at 24 hrs after closure. Of those with LVEF < 55% at 24 hrs, all normalized before discharge. Conclusion In preterm neonates who underwent successful transcatheter PDA closure, 23% developed abnormal LVEF after closure and those with significant LV dilation prior to the procedure were at increased risk for the development of LVEF < 55% after closure.