Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T05:27:54.417Z Has data issue: false hasContentIssue false
  • English
  • Français

Thrombocytopenia associated with transcatheter closure of giant patent ductus arteriosus

Published online by Cambridge University Press:  13 October 2020

Lei Liu ,
Peng Yue ,
Xiaolan Zheng ,
Hongyu Liao ,
Jiawen Li ,
Yimin Hua ,
Yifei Li Open the ORCID record for Yifei Li [Opens in a new window]  and
Kaiyu Zhou
Lei Liu
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Peng Yue
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Xiaolan Zheng
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Hongyu Liao
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Jiawen Li
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Yimin Hua
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Yifei Li*
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Kaiyu Zhou*
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
*
Author for correspondence: Yifei Li, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501352; Fax: +86 28 85501056. E-mail: [email protected]; Kaiyu Zhou, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501059; Fax: +86 28 85501059. E-mail: [email protected]
Author for correspondence: Yifei Li, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501352; Fax: +86 28 85501056. E-mail: [email protected]; Kaiyu Zhou, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501059; Fax: +86 28 85501059. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Thrombocytopenia occasionally occurs following the closure of some giant patent ductus arteriosus cases. Unfortunately, there is no associated research describing the associated risk factors for thrombocytopenia post-procedure.

Methods:

We reviewed all patients who received occluders with sizes ≥10/12 mm between January 2013 and June 2019. All the data and information on the characteristics of the patients and their follow-up were recorded. Univariate analysis, receiver operating characteristic curves, and linear regression were used to analyse the risk factors for thrombocytopenia and the predictors of hospitalisation stay.

Results:

Finally, 32 patients (17.5%) suffered from thrombocytopenia. Univariate analysis revealed the ratio between occluder disc size (mm) and body weight (kg) (1.71 ± 0.51 versus 1.35 ± 0.53) as an independent predictive factor for thrombocytopenia, and the area under the curve of the ratio of occluder size and body weight for predicting thrombocytopenia post-closure was 0.691 (95% confidence interval: 0.589–0.792, p = 0.001). The best cut-off value for the ratio of occluder size and weight was 1.5895, with a sensitivity and specificity of 68.8 and 66.9%, respectively. Each unit of the ratio of occluder size and body weight predicted an average hospitalisation stay of 2.856 days (95% confidence interval: 1.380–4.332). Treatment with medication did not reduce the hospitalisation stay or benefit platelet restoration.

Conclusion:

Once the ratio of occluder size and body weight is greater than 1.6, thrombocytopenia always exists. Every unit of the ratio of occluder size and body weight represents an additional 3 days of hospitalisation. Treatment does not reduce the duration of hospitalisation.

Keywords

Thrombocytopeniatranscatheter closuregiant patent ductus arteriosusrisk factors
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1896 - 1901
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors contributed equally to this article.

References

Shah, JH, Bhalodiya, DK, Rawal, AP, Nikam, TS. Long-term results of transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension in pediatric patients. Int J App Basic Med Res 2020; 10: 3–7.CrossRefGoogle ScholarPubMed
Malekzadeh-Milani, S, Akhavi, A, Douchin, S, et al. Percutaneous closure of patent ductus arteriosus in premature infants: a French national survey. Catheter Cardiovasc Interv 2020; 95: 71–77.CrossRefGoogle ScholarPubMed
O’Byrne, ML, Millenson, ME, Grady, CB, et al. Trends in transcatheter and operative closure of patent ductus arteriosus in neonatal intensive care units: analysis of data from the Pediatric Health Information Systems Database. Am Heart J 2019; 217: 121–130.CrossRefGoogle ScholarPubMed
Morville, P, Akhavi, A. Transcatheter closure of hemodynamic significant patent ductus arteriosus in 32 premature infants by amplatzer ductal occluder additional size-ADOIIAS. Catheter Cardiovasc Interv 2017; 90: 612–617.CrossRefGoogle ScholarPubMed
Jin, M, Liang, YM, Wang, XF, et al. A retrospective study of 1,526 cases of transcatheter occlusion of patent ductus arteriosus. Chin Med J 2015; 128: 2284–2289.CrossRefGoogle ScholarPubMed
Kang, SL, Morgan, G, Forsey, J, Tometzki, A, Martin, R. Long-term clinical experience with Amplatzer Ductal Occluder II for closure of the persistent arterial duct in children. Catheter Cardiovasc Interv 2014; 83: 1102–1108.CrossRefGoogle ScholarPubMed
Kim, HS, Schechter, MA, Manning, PB, et al. Surgical versus percutaneous closure of PDA in preterm infants: procedural charges and outcomes. J Surg Res 2019; 243: 41–46.CrossRefGoogle ScholarPubMed
Gupta, K, Rao, PS. Severe intravascular hemolysis after transcatheter coil occlusion of patent ductus arteriosus. J Invasive Cardiol 2005; 17: E15–E17.Google ScholarPubMed
Po Zhang, M, Xian-yang, Zhu. Severe thrombocytopenia complicating transcatheter occlusion of a patent ductus arteriosus. J Invasive Cardiol 2013; 25: E88–E92.Google Scholar
Schneider, DJ, Moore, JW. Patent ductus arteriosus. Circulation 2006; 114: 1873–1882.CrossRefGoogle ScholarPubMed
Feltes, TF, Bacha, E, Beekman, RH 3rd, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011; 123: 2607–2652.CrossRefGoogle ScholarPubMed
Ghasemi, A, Pandya, S, Reddy, SV, et al. Trans-catheter closure of patent ductus arteriosus – what is the best device? Catheter Cardiovasc Interv 2010; 76: 687–695.CrossRefGoogle ScholarPubMed
Vavuranakis, M, Tzannos, KA, Thanopoulos, BD, Vlasis, K, Stefanadis, C. Severe hemolysis complicating transcatheter occlusion of a patent ductus arteriosus – the importance of elimination of residual flow. Hellenic J Cardiol 2007; 48: 373–376.Google ScholarPubMed