Saurabh KapoorMax Superspeciality Hospital, India
Title: Percutaneous PDA closure in extremely low birth weight baby using Amplatzer Piccolo Occluder device
A 29 weeks preterm baby born to a primigravida mother with preterm cesarean section in view of severe pregnancy induced hypertension with pre eclampsia with leaking per vagina. Baby weighed 900 grams at birth and had respiratory distress with hyaline membrane disease for which baby was given 1 dose of surfactant using INSURE technique. In view of persistent respiratory distress, feed intolerance and 2D echo showing hsPDA, medical management was given with paracetamol and two courses were done. Symptoms persisted even after medical management and PDA persisted. In view of clinical picture, decision was taken to go for percutaneous transcatheter closure of PDA. Necessary accommodations were made for transport from neonatal intensive care unit, ventilation, prevention of hypothermia and backup of blood products. The Amplatzer Piccolo Occluder device was used for closure of hsPDA. The procedure was performed using femoral approach under fluoroscopy guidance. The procedure was done with no complications during the course of procedure. Baby had post procedure hypertension (>90™ centile) which was managed with sodium nitroprusside. Repeat echo was done to check for device, cardiac functioning, aortic and pulmonary blood flow. Gradually FiO2 requirement decreased by 48 hours and baby came to room air by day 3 post procedure. Feeds were increased and were tolerated well. Baby was kept on regular follow up and repeat 2D echo showed closure of PDA with device in position, good cardiac function with good flows in pulmonary artery, aorta and no tricuspid regurgitation.
Saurabh Kapoor has completed his Diplomate of National Board in Pediatrics. He completed his fellowship in Neonatology from the prestigious Indian Academy of Pediatrics and is a life member of National Academy of medical sciences & national neonatology forum. His areas of interest are neonatal ventilation, point of care ultrasonography, infection control, pediatric nutrition and growth & Development of children. He has original research published in national and international journals and presented papers oral/poster on national & international forums.