Cardiovascular Pharmacology: Open Access

Minimal radiation exposure transcatheter patent ductus arteriosus closure using only venous access: A novel technique

11^th World Congress on Pediatric Cardiology and Congenital Cardiovascular Disease

April 18-19, 2017 London, UK

Nurul Islam

The Mission Hospital, India

Scientific Tracks Abstracts: Cardiovasc Pharm

Abstract:

Objective: The transcatheter closure of Patent Ductus Arteriosus (PDA), as well as other pediatric cardiac interventions has raised the concerns regarding radiation exposure, particularly relevant while treating children. The purpose of this study is to show how to perform the transcatheter closure of PDA in children while giving less ionized radiation exposure and to prove that the amount of radiation can be reduced by using pressure trace during catheter manipulation. This is a prospective analysis of feasibility, safety and advantages of doing PDA device closure using only venous access under minimal radiation. Background: Taking an arterial access for transcatheter device closure has been a standard practice but has some inherent complications. The use of radiation or fluoroscopy is necessary but it has some ill effects on tissues, especially in children because of their greater sensitivity compared to adults and also for health care providers inside catheterization laboratory for continuous exposure. Method: As per our departmental policy, we decided to go for PDA device closure only through venous access in the beginning of March 2016 till date. We decided to reduce the radiation time during the procedure by different techniques; most important was entry into right ventricle and sometime till pulmonary artery under pressure tracing guidance. Echocardiography was used for patient selection and assessment for sizing of device and procedural outcome. Result: 112 out of 145 patients underwent PDA device closure from March 2016 over 10 months with only venous access and under minimal radiation technique, weighing 3.8-42 kg with half of them <10 kg. Fluoroscopic time ranged from 0.04 to 2.12 minutes. Twelve patients had difficulty in entering right ventricle from right atrium and required fluoroscopic guidance. Immediate closure was achieved in 105 patients. Two syndromic babies had mild flow acceleration across left pulmonary artery and two patients had small intra-device shunt at 3 months of follow up. Conclusion: PDA device closure can be comfortably done without an arterial access. Patients can be exposed to significant less radiation if catheter manipulation was done under pressure tracing compared to conventional procedure of fluoroscopic guidance.

Biography :

Nurul Islam has completed his graduation in Medical Science from Calcutta National Medical College, India. He has done his Post-graduation in Pediatrics from Vivekananda Institute of Medical Sciences under the West Bengal University of Health Sciences in 2010. He completed his Fellowship in Pediatric Cardiology under Diplomate National Board (DNB) from Indraprastha Apollo Hospitals, Delhi and has done his training in Advanced Pediatric Cardiac Intervention from Evelina Children Hospital, Guys and St Thomas Trust in UK. Currently, he is working as a Consultant Interventional Pediatric Cardiologist at the Mission Hospital.

Email: nurulpedscardio@gmail.com