Short-and-medium term outcomes of Piccolo Device closure of patent ductus arteriosus in premature infants: A single center review

Introduction: Obstruction of the left pulmonary artery (LPA) or descending aorta requiring late intervention is a rare complication after transcatheter closure with Piccolo device, but a multidisciplinary approach is often needed to discover and manage the patient when it does occur. We report our center’s experience with the Piccolo device, including 3 cases of late LPA stenosis requiring surgical debridement and pulmonary artery plasty. Methods: Retrospective chart review of 60 patent ductus arteriosus closures using Amplatzer Piccolo device in premature infants. Results: 60 cases of device closure in premature infants. Transient LPA stenosis was noted in 8% of patients, LPA stenosis requiring surgical intervention in 5% of patients. LPA velocity of 2.7 m/s at any point following device placement by echocardiogram, and right pulmonary artery (RPA) to LPA ratio of 1.5 to 1 by 2D echo are predictive indicators of need for surgical intervention. Differential lung perfusion scans may also provide important prognostic and follow-up data after intervention. Conclusion: Transient LPA stenosis is expected after device closure of a patent ductus arteriosus in premature infants. A multidisciplinary approach and vigilant follow-up are required to discover late complications including LPA occlusion and manage the patient when it does occur.