A better option for the tiniest babies
The new procedure works by creating a small incision in the patient's thigh and guiding the device through blood vessels to reach the heart. The device is incredibly thin, as small as 3 millimeters, which allows it to smoothly seal the duct opening without causing any obstruction.
The premature newborns are fragile and require a well-controlled environment. A multidisciplinary team — including anesthesia, imaging, the Neonatal Intensive Care Unit (ICU) , and the Catheterization Laboratory — collaborates to ensure the Catheterization Laboratory conditions are close to the Neonatal ICU.
“We have four teams, with multiple staff in each one, working in harmony together in the cath lab to make sure this procedure is done safely,” says Osamah Aldoss, MBBS, MD, director of the Pediatric Catheterization Laboratory. “That’s the key for success.”
Due to the novelty of this procedure, UI staff received specialized training, as it is unlike other heart operations completed in the state.
When Race Fuller was born at 23 weeks he weighed just 1 pound and was immediately in critical condition due to PDA. His UI care team advised that the best option for his treatment was the Amplatzer Piccolo device, considering his small size.
Before this device became available, the only option was surgery, which comes with a higher risk of vocal cord paralysis, collapsed lungs, and other serious issues.
"The direct surgical complications that can happen, either trauma or other significant deterioration, are much less likely with this device," says Patrick McNamara, MD, director of the neonatology division in the Stead Family Department of Pediatrics.
His mother, Kristin Fuller, says she was comfortable going forward with this new procedure because the medical team was confident in their capabilities.
After the procedure, the staff was able to wean Race off his ventilator support, and just two weeks later he was extubated.
"It was actually like night and day," Kristin Fuller says. "A couple days after the procedure he was better. It was miraculous."
The UI Stead Family Children's Hospital team has successfully performed roughly 17 procedures so far. The latest evidence from studies around the country suggests this device is about 98% successful.
"They've been smooth procedures, and there's been no major complications," McNamara says. "We have a well-organized team and this device is the future for PDA closure in extremely preterm babies."