Utility of Follow-up Echocardiograms in Uncomplicated PDA Device Closures Performed During Infancy

Background: Current guidelines recommend lifelong follow-up with intermittent echocardiograms for patients who had a patent ductus arteriosus (PDA) device closure via catheterization. Minimal data exist determining the utility of follow up echocardiograms in patients who had an uncomplicated device placement during infancy. Goal of this study was to document if follow up echocardiograms changed clinical course in patients who had an initial uncomplicated device course.

Methods: Retrospective chart review was performed on all patients who had a PDA device placement < 1 year of age between 1/1/2002 – 6/1/2020. Patients were excluded if they had other congenital heart disease, did not have a follow-up echocardiogram > 3 months after procedure, had a velocity > 2.0 m/s in the left pulmonary artery (LPA) or descending aorta (DAo) on the first echocardiogram > 3 months after device placement, or if they died < 1 year after PDA procedure. Echocardiographic time points included the first echocardiogram after the procedure, first echocardiogram > 3 months after procedure, and the most recent echocardiogram. Clinical outcomes were documented.

Results: Total of 144 patients met criteria. Age and weight at initial procedure were 141 + 217 days (median 94 days, 29 – 363) and 4.2 + 2.8 kg (median 3.2 kg, 0.9 – 11.7). Echocardiographic data are presented in Table 1. There was no significant difference in DAo velocity between initial to most recent echocardiogram. LPA velocity and left ventricular diastolic Z-score significantly decreased between initial to most recent echocardiogram. Seventy-eight patients had repeat echocardiograms > 1 year after PDA procedure with no change in clinical management noted. No patient underwent an intervention on the LPA or DAo for stenosis.

Conclusion: In patients who underwent an uncomplicated PDA closure during infancy, echocardiographic parameters either stayed stable or improved over time. Repeat lifetime echocardiograms in this population may not necessarily be needed if there are no clinical concerns.