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The KA micro plug device (KA Medical, Minneapolis, MN) has several advantageous features for transcatheter patent ductus arteriosus (PDA) closure in premature infants, particularly patients weighing less than 1500 grams, owing to its small profile and soft delivery system. Experience using KA devices in PDA closure is lacking. This was a retrospective single-center study for all premature infants weighing less than 1500 grams who underwent attempted PDA closure using the KA micro plug from February 2022 to December 2023 at Stead Family Children's Hospital. The delivery microcatheter was modified. Special techniques were used to shorten the procedure time and involved the preparation, loading, and deployment of the devices. Descriptive statistics were used. In total, 18 premature infants underwent attempted transcatheter PDA closure using the KA micro plug device, achieving a 100% success rate. Median weight, age, and corrected gestational age at the procedure were 943 (682-1225) grams, 26 (9-79) days, and 28.5 (25.6-32) weeks, respectively. Median procedure and fluoroscopy times were 28.5 (18-53) minutes and 4.6 (2.2-9.4) minutes, respectively. Median radiation doses, expressed as dose area product and air kerma, were 1.81 (0.49-3.23) μGy.m2 and 1.28 (0.41-2.74) mGy, respectively. Closure was achieved in all patients, with no hemodynamic instability noted during the procedures. Normal flow in the left pulmonary artery and aortic arch was observed in all cases before and after closure. No catheter-induced tricuspid valve regurgitation or instances of device embolization or malpositioning occurred. On a median follow-up of 10.9 (0.1-19) months, all patients were alive with the device in an acceptable position, and no residual shunt or abnormal echocardiogram findings were noted. The KA micro plug device can be safely used to close PDAs in small, premature infants when appropriate modifications to the delivery catheter and deployment techniques are implemented.
Nijres et al. (Wed,) studied this question.