title: Morphologic characterization of the patent ductus arteriosus in the premature infant and the choice of transcatheter occlusion device.
abstract: OBJECTIVE
  The aim of this study was to describe and differentiate the morphology of patent ductus arteriosus (PDA) seen in children born prematurely from other PDA types.
  
  
  BACKGROUND
  PDAs are currently classified as types A-E using the Krichenko's classification. Children born prematurely with a PDA morphology that did not fit this classification were described as Type F PDA.
  
  
  METHODS
  A review of 100 consecutive children who underwent transcatheter device closure of PDA was performed. The diameter and length (L) of the PDA and the device diameter (D) were indexed to the descending aorta (DA) diameter.
  
  
  RESULTS
  Comparison of 26 Type F PDAs was performed against, 29 Type A, 7 Type C and 32 Type E PDAs. Children with Type F PDAs (median 27.5 weeks gestation) were younger during the device occlusion compared with types A, C, and E (median age: 6 vs. 32, 11, and 42 months; P = 0.002). Type F PDAs were longer and larger, requiring a relatively large device for occlusion than types A, C, and E (Mean L/DA: 1.88 vs. 0.9, 1.21, and 0.89, P ≤ 0.01 and Mean D/DA: 1.04 vs. 0.46, 0.87, and 0.34, P ≤0.01). The Amplatzer vascular plug-II (AVP-II) was preferred for occlusion of Type F PDAs (85%; P <0.001).
  
  
  CONCLUSIONS
  Children born prematurely have relatively larger and longer PDAs. These "fetal type PDAs" are best classified separately. We propose to classify them as Type F PDAs to add to types A-E currently in use. The AVP-II was effective in occluding Type F PDAs.
authors.affiliation: Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Philip
authors.affiliation: Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: B Rush
authors.initials: BR
authors.lastname: Waller
authors.affiliation: Department of Radiology, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Vijaykumar
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Dena
authors.initials: D
authors.lastname: Wright
authors.affiliation: Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Arevalo
authors.affiliation: Department of Biostatistics, Harvard Medical School, Boston, Massachusetts.
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.affiliation: Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.|Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee.
authors.forename: Shyam
authors.initials: S
authors.lastname: Sathanandam
mesh_terms: D001027:Aortography; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D004373:Ductus Arteriosus / Q000002:abnormalities / Q000000981:diagnostic imaging*; D004374:Ductus Arteriosus, Patent / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D018618:Echocardiography, Doppler, Color; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012189:Retrospective Studies; D055989:Septal Occluder Device; D009626:Terminology as Topic; D016896:Treatment Outcome
keywords: congenital heart disease; patent ductus arteriosus; pediatric interventions; prematurity; preterm infant; transcatheter device closure