title: Transcatheter elimination of left-to-right shunts in infants with bronchopulmonary dysplasia is feasible and safe.
abstract: OBJECTIVE
  To test the hypothesis that transcatheter elimination of left-to-right (L-R) cardiac shunts in former premature infants with bronchopulmonary dysplasia (BPD) is feasible, safe, and is associated with an improvement in respiratory status.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Twelve patients with BPD who underwent an attempt at transcatheter closure of an L-R shunt lesion within the first year of life at a single center. Median weight was 5.4 kg and median age was 6 months. Fifteen L-R shunt lesions included patent ductus arteriosus (n = 1), atrial septal defect (ASD) (n = 9), and aortopulmonary collaterals (n = 5).
  
  
  METHODS
  Echocardiographic and clinical markers were collected before and after intervention as well as procedural variables including successful elimination of the shunt and procedural complications.
  
  
  RESULTS
  The L-R shunts were successfully occluded in 11/12 (91.6%) patients without any significant procedural adverse event. The ASD closure group demonstrated a decrease in right heart size after the procedure. All patients required respiratory support prior to, and 1 month after, the procedure while only 5/10 (50%) required respiratory support at 12 months of age (P = .0129). There was no change in the median weight percentile over time.
  
  
  CONCLUSIONS
  Transcatheter occlusion of L-R shunts can be performed safely and effectively in children with BPD. Further studies may clarify the role of such therapy in improvement in respiratory physiology over time.
authors: The Heart Center Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA.
authors: Amy M
authors: AM
authors: Wood
authors: Ralf J
authors: RJ
authors: Holzer
authors: Karen M
authors: KM
authors: Texter
authors: Sharon L
authors: SL
authors: Hill
authors: Alfred L
authors: AL
authors: Gest
authors: Stephen E
authors: SE
authors: Welty
authors: John P
authors: JP
authors: Cheatham
authors: Andrew R
authors: AR
authors: Yates
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects; D016009:Chi-Square Distribution; D003326:Coronary Circulation; D005240:Feasibility Studies; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000503:physiopathology*; D018579:Patient Selection; D020127:Recovery of Function; D012121:Respiration, Artificial; D012138:Respiratory Therapy / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography