Percutaneous Closure of Patent Ductus Arteriosus in Infants ≤1.5 kg: A Meta-Analysis.

OBJECTIVE To investigate technical success and safety of percutaneous patent ductus arteriosus (PDA) closure in infants ≤1.5kg. STUDY DESIGN A systematic review and meta-analysis was performed. Data sources included Scopus, Web of Science, Embase, CINAHL, Cochrane, PubMed from inception to April 2020. Publications were included if they had a clear definition of the intervention as percutaneous PDA closure in infants ≤1.5kg. Data extraction was independently performed by multiple observers. Primary outcome was technical success and secondary outcomes were adverse events (AEs). Subgroup analysis was performed in infants <6kg. Data were pooled by using a random-effects model. RESULTS 28 studies, including 373 infants <1.5kg and 69 studies enrolling 1794 infants <6kg were included. In patients <1.5kg, technical success was 96% (95% CI 93-98%, p=0.16, I2=23%). Overall incidence of AE was 27% (95% CI 17-38%, p<0.001, I2=70%) and major AEs was 8% (95% CI 5-10%, p=0.63, I2=0%). There were 5 deaths related to the procedure [2% (95% CI 1-4%, p=1, I2=0%)]; 4 of these deaths occurred in infants <0.8kg. The probability of technical failure was inversely related to age at the time of the procedure [OR 0.9 (95% CI 0.830-0.974), P = .009]. Weight at intervention has decreased over time and procedural success has increased. CONCLUSIONS Percutaneous PDA closure is feasible in infants ≤1.5kg with few major AEs. Procedural success rate is high, despite performing intervention in smaller patients.