Radiation exposure and the effect of anti-scatter grids are not well studied in premature infants during transcatheter patent ductus arteriosus closure.

This study aimed to investigate whether the use of anti-scatter grids altered the level of radiation exposure to premature infants undergoing transcatheter patent ductus arteriosus closure.

Demographic and radiation exposure data for premature infants who underwent transcatheter patent ductus arteriosus closure at the Stead Family Children’s Hospital from 10/2019 to 10/2021 were retrospectively reviewed and analyzed. Twenty-four patients (41%) underwent transcatheter patent ductus arteriosus closure with anti-scatter grids, while 34 (59%) underwent the procedure without using anti-scatter grids. At the time of catheterization, the median age, corrected age, and weight were 4.3 weeks (3.4–6), 29 weeks (28.1–30.9), and 1200g (1000-1600), respectively. Total radiation exposures for the dose area product and air kerma were 2.73 µGy.m2 (1.65–4.16), and 1.63 mGy (1.15–2.58), respectively. Radiation doses were higher in the group in whom the anti-scatter grids were utilized with dose area product of 3.33 µGy.m2 (2.39–5.43) and air kerma of 2.27 mGy (1.41–3.06) versus 1.86 µGy.m2 (1.46–3.60) and air kerma of 1.40 mGy (1.08–1.92). When radiation doses were adjusted to the radiation time, no difference in radiation exposure was noticed between the groups.

Transcatheter patent ductus arteriosus closure in premature infants can be safely performed with minimal radiation exposure. In the authors’ laboratory, the use of anti-scatter grids does not impact radiation exposure in premature infants.

Transcatheter patent ductus arteriosus closure in premature infants is gaining attention with rapidly growing experience. The KA micro plug device poses many favourable features for ductus arteriosus closure in premature infants. The study aimed to describe the technique and outcomes of a KA micro plug in closing the ductus arteriosus in premature infants weighing less than 1500 g.

This is a single-centre retrospective study in premature infants with patent ductus arteriosus weighing less than 1500 g who underwent off-label use of a KA micro plug at the Stead Family Children’s Hospital from February 2022 to December 2023.

Eighteen premature infants weighing less than 1500 g underwent attempted transcatheter ductus arteriosus closure using a KA micro plug device. Median weight, age, and corrected gestational age at the procedure were 943 g (682–1225), 26 days (9–79), and 28.5 weeks (25.6–32), respectively. The procedure was successful with complete closure achieved in all patients. No major haemodynamic instabilities were encountered. No catheterization-related complications were encountered. On a median follow-up of 10.9 months (0.1–19), all patients are alive with the device in a good position without residual shunt or abnormal findings.

KA micro plug device for patent ductus arteriosus in infants weighing less than 1500 g is feasible, safe, and effective. We recommend that manufacturers of devices used to close the ductus arteriosus in small infants enhance both the devices and their delivery systems to simplify the procedure and mitigate the risk of haemodynamic instability.

Although percutaneous closure of patent ductus arteriosus is an established safe procedure, protrusion of the device to descending aorta may occur in various degrees during these procedures, especially in small infants. The aim of our study is to evaluate the benefits of balloon-assisted device releasing technique in the era of preventing device protrusion and conditions related to protrusion.

One hundred and fifty-five infants, who underwent patent ductus arteriosus closure with Amplatzer duct occluder I device between January, 2012 and December, 2018, were retrospectively analysed. Balloon-assisted device releasing technique was used in 20 cases (group 1, 12.9%), between January, 2015 and December, 2018. Procedures in which the technique had been used were compared with the remaining ones (group 2, 87.1%, n = 135) with regard to device stabilisation, aortic disc protrusion to the aorta, iatrogenic coarctation, and device embolisation.

There was no significant difference by means of gender, age, weight, and the ductal diameter, whereas the average mean pulmonary artery pressure was significantly higher in group 1. Device protrusion and related complications were significantly higher in group 2; thus, additional catheterisations or surgical interventions were required, while no additional intervention was required in group 1.

The balloon-assisted device releasing technique provides a good device stabilisation and prevents protrusion of the device and related complications during percutaneous patent ductus arteriosus closure in selected cases.