WIP 51 - Comparing Echocardiographic and Angiographic Measurements of the Patent Ductus Arteriosus in Infants

Publication Number: WIP 51.7460

BRYSTON CHANG, University of California, Irvine, School of Medicine, Orange, CA, United States; Madison Huffman, University of California, Irvine, School of Medicine, Orange, CA, United States; Shawn Sen, CHOC Children's Hospital of Orange County, Irvine, CA, United States; Monica Sondhi, Children’s Hospital of Orange County, Orange, CA, United States; Gira Morchi, CHOC Children's Hospital of Orange County, Orange, CA, United States; Rhucha Joshi, CHOC Children's Hospital of Orange County, Orange, CA, United States; Muhammad Aslam, CHOC/ UCI, Orange, CA, United States; Amir H. Ashrafi, CHOC Children's Hospital, Newport Coast, CA, United States; James Hammond, University of California, Irvine, Dana Point, CA, United States

Background: Patent ductus arteriosus (PDA) is a common complication of prematurity. Hemodynamically significant PDAs may lead to pulmonary over-circulation, increased respiratory support, necrotizing enterocolitis, and renal insufficiency. Significant PDAs that fail to respond to medical therapy are often referred for transcatheter device closure. Device size depends upon PDA diameter and length. There are limited single center studies comparing the accuracy of PDA measurements by transthoracic echocardiography to intra-procedural angiography, and no studies examine whether discordant measurements between the two impact outcomes.

Objective: Compare concordance between PDA diameter and length obtained by transthoracic echocardiography to measurements obtained via angiography at time of device closure. Examine outcomes associated with discordant measurements, namely mispositioning of device, need for multiple device deployments, and residual shunt after placement.

Design/Methods: IRB approval was obtained. A retrospective review was performed on 70 infants who met the inclusion criteria. Demographic information and select clinical variables prior to device closure were obtained. PDA ampulla/pulmonary insertion diameter, length, and PDA morphology will be measured by a blinded observer on last echocardiogram performed prior to device closure. Corresponding angiographic measurements will be extracted from the Pedcath registry as reported by interventional cardiologist during the procedure along with procedural time, fluoroscopy time, and issues related to proper device positioning. Bland-Altman analysis will be conducted to assess agreement and identify proportional bias between measurements. Proportional bias will be evaluated through linear regression of measurement differences on average values from the two methods. Intraclass correlation and interrater reliability will be assessed for both measurements. Associations between discordant measurements and outcomes will be evaluated.