title: Percutaneous Patent Ductus Arteriosus (PDA) Closure During Infancy: A Meta-analysis.
abstract: BACKGROUND
  Patent ductus arteriosus (PDA) is a precursor to morbidity and mortality. Percutaneous (catheter-based) closure is the procedure of choice for adults and older children with a PDA, but use during infancy (<1 year) is not well characterized.
  
  
  OBJECTIVE
  Investigate the technical success and safety of percutaneous PDA closure during infancy.
  
  
  METHODS
  Scopus, Web of Science, Embase, PubMed, and Ovid (Medline) were searched through December 2015 with no language restrictions.
  
  
  METHODS
  Publications needed to clearly define the intervention as percutaneous PDA closure during infancy (<1 year of age at intervention) and must have reported adverse events (AEs).
  
  
  METHODS
  The study was performed according to the Systematic Reviews and Meta-Analysis checklist and registered prospectively. The quality of the selected studies was critically examined. Data extraction and assignment of AE attributability and severity were independently performed by multiple observers. Outcomes were agreed on a priori. Data were pooled by using a random-effects model.
  
  
  RESULTS
  Thirty-eight studies were included; no randomized controlled trials were found. Technical success of percutaneous PDA closure was 92.2% (95% confidence interval [CI] 88.8-95.0). Overall AE and clinically significant AE incidence was 23.3% (95% CI 16.5-30.8) and 10.1% (95% CI 7.8-12.5), respectively. Significant heterogeneity and publication bias were observed.
  
  
  CONCLUSIONS
  Limitations include lack of comparative studies, lack of standardized AE reporting strategy, and significant heterogeneity in reporting.
  
  
  CONCLUSIONS
  Percutaneous PDA closure during infancy is feasible and associated with few catastrophic AEs; however, the limitations constrain the interpretability and generalizability of the current findings.
authors.affiliation: Centers for Perinatal Research, carl.backesjr@nationwidechildrens.org.|Cardiovascular and Pulmonary Research, and.|The Heart Center, The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, Columbus, Ohio.|Department of Pediatrics, The Ohio State University, Columbus, Ohio.
authors.forename: Carl H
authors.initials: CH
authors.lastname: Backes
authors.affiliation: Centers for Perinatal Research.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Rivera
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, Ohio.|Innovation in Pediatric Practice, and.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bridge
authors.affiliation: Cardiovascular and Pulmonary Research, and.|The Heart Center, The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, Columbus, Ohio.|Department of Pediatrics, The Ohio State University, Columbus, Ohio.
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Armstrong
authors.affiliation: Cardiovascular and Pulmonary Research, and.|The Heart Center, The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, Columbus, Ohio.|Department of Pediatrics, The Ohio State University, Columbus, Ohio.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Boe
authors.affiliation: Cardiovascular and Pulmonary Research, and.|The Heart Center, The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, Columbus, Ohio.|Department of Pediatrics, The Ohio State University, Columbus, Ohio.
authors.forename: Darren P
authors.initials: DP
authors.lastname: Berman
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, Ohio.
authors.forename: Tyler
authors.initials: T
authors.lastname: Fick
authors.affiliation: Department of Pediatrics, Weill Cornell Medical College, New York, New York.|Cardiac Catheterization and Interventional Therapy, Sidra Cardiac Program, Sidra Medical and Research Center, Doha, Qatar.
authors.forename: Ralf J
authors.initials: RJ
authors.lastname: Holzer
authors.affiliation: Department of Pediatrics, Weill Cornell Medical College, New York, New York.|Cardiac Catheterization and Interventional Therapy, Sidra Cardiac Program, Sidra Medical and Research Center, Doha, Qatar.
authors.forename: Ziyad M
authors.initials: ZM
authors.lastname: Hijazi
authors.affiliation: Department of Pediatric Cardiology, CHU mère-enfant Sainte-Justine, Université de Montréal, Quebec, Canada.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Abadir
authors.affiliation: Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Henri
authors.initials: H
authors.lastname: Justino
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bergersen
authors.affiliation: Center for Developmental Therapeutics, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, Washington; and.
authors.forename: Charles V
authors.initials: CV
authors.lastname: Smith
authors.affiliation: Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Haresh
authors.initials: H
authors.lastname: Kirpalani
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D000068456:Clinical Studies as Topic; D004374:Ductus Arteriosus, Patent / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D012449:Safety; D055989:Septal Occluder Device; D016896:Treatment Outcome