Ochsner Offers PDA Closure for Babies with Extremely Low Birth Weight
Ochsner Hospital for Children is the only program in Louisiana, Mississippi and Alabama to offer a noninvasive solution for extremely low birth weight (under 1000 grams or 2 pounds, 3 ounces) babies with a structural heart condition known as patency of the ductus arteriosus (PDA).
All newborns have a blood vessel called a ductus arteriosus that directs blood to go around the developing lungs while a baby is in the womb. If functioning properly, this blood vessel naturally closes in the first few days after delivery. When this blood vessel fails to close on its own, too much blood is directed to the lungs of the baby instead of going to other parts of the body. If left untreated, a PDA causes both the heart and lungs to work harder than normal, resulting in difficulty breathing, feeding problems, blood circulation issues or even heart failure.
Signs a baby may have a PDA include rapid breathing and a forceful pulse. To check for a PDA, a doctor uses a stethoscope to listen for a heart murmur before obtaining x-rays and an echocardiogram to confirm the diagnosis and size of the blood vessel. Depending on the size of the PDA, some babies may only require observation in the neonatal intensive care unit (NICU), while others may need medicine or even surgery.
Working closely with neonatologists at Ochsner Baptist – A Campus of Ochsner Medical Center, the pediatric cardiology team at Ochsner Hospital for Children offers a non-invasive alternative to surgery – successfully performing the PDA closure in a catherization lab (cath lab) on babies with extreme low birth weight, as small as 550 grams (below 1.5 pounds). During the procedure, a small tube (or catheter) is inserted into a blood vessel in the baby’s leg and carefully guided up to the heart. Attached to the catheter is a pea-sized closure device made of a self-expanding mesh alloy called an Amplatzer Piccolo™ Occluder that is used to plug the blood vessel (ductus arteriosus) thereby stopping the extra blood flow to the lungs.
“Offering noninvasive PDA closures delivers powerful results with less recovery time. It has made a huge difference in the wellbeing and overall health of the babies we care for, especially those with low or extreme low birth weight. Ochsner has become a destination – both across the state and beyond – for PDA closures for premature babies. It’s one of the many reasons why we are a leader for pediatric cardiac care in our region,” said Ivory Crittendon, III, MD, Senior Physician, Pediatric Cardiology, Ochsner Hospital for Children.
Approximately one in every 12 babies is born with a low birthweight (5 pounds, 8 ounces or less). Although babies born full term can have a PDA, it is more commonly found in babies born prematurely (before 37 weeks gestation). Across the United States one in every 10 babies is born premature. In Louisiana, that number is even higher with a 13 percent preterm birth rate, making it the second-highest state in the country for preterm births.
“As Louisiana’s only level IV NICU with a level IV Labor and Delivery unit, we care for some of the most critically ill babies in our State. Many of these patients are born preterm and some have extremely low birth weights,” said Harley Ginsberg, MD, Section Head, Neonatology, and Medical Director of the NICU at Ochsner Baptist Medical Center. “To be able offer them and their family this procedure (transcatheter occlusion) instead of invasive surgery has been a true gamechanger for these little ones. The follow up chest x-rays frequently show prompt improvement of lung function and rarely are any pain medications required after the procedure. With a shorter recovery time, babies resume feedings sooner and tend to wean more rapidly from ventilatory support.”
Cardiology at Ochsner
For the third year in a row, Ochsner Hospital for Children has been named among the top 50 children’s hospitals in the country by U.S. News & World Report, the global authority in hospital rankings and consumer advice. Ochsner Hospital for Children was recognized in two specialties, cardiology and heart surgery and gastroenterology and gastrointestinal surgery.
Ochsner offers the only pediatric heart transplant program in the state of Louisiana and its Pediatric and Adult Congenital Cardiac Surgery Program’s 2018 surgical outcomes greatly exceeded national averages.Ochsner achieved 100% survival in neonatal and child heart surgeries and in the Norwood Procedure, used to treat hypoplastic left heart syndrome.
The congenital cardiovascular team at Ochsner Hospital for Children is comprised of more than 20 congenital cardiologists, interventional congenital cardiologists and congenital heart surgeons. The team works closely with the John Ochsner Heart and Vascular Institute (JOHVI) to ensure coordination of care for patients of all ages with congenital heart disease – from the tiniest of babies to adults.
JOHVI has been a regional and national leader in cardiology and cardiac surgery for decades. JOHVI is one of 14 hospitals in the United States to have completed 1000 heart transplants and performed its 500th LVAD (left ventricular assist device) in 2017.
The JOHVI team of more than 50 cardiologists and surgeons work closely with each patient to develop a customized healthcare plan that is both targeted and effective. JOHVI also participates in more than 100 clinical trials for the goal of advancing knowledge of the mechanisms, treatments and diagnoses of cardiovascular disease.
For more information about Ochsner’s pediatric cardiology program, visit https://www.ochsner.org/services/pediatric-cardiology. For more information or to make an appointment with an Ochsner cardiologist, visit www.ochsner.org/heart.
About Ochsner Health System
Ochsner Health System is Louisiana’s largest non-profit, academic, healthcare system. Driven by a mission to Serve, Heal, Lead, Educate and Innovate, coordinated clinical and hospital patient care is provided across the region by Ochsner's 40 owned, managed and affiliated hospitals and specialty hospitals, and more than 100 health centers and urgent care centers. Ochsner is the #1 ranked hospital in Louisiana by U.S. News & World Report and is recognized as a “Best Hospital” across two specialty categories caring for patients from all 50 states and more than 70 countries worldwide each year. Ochsner Hospital for Children is the only facility in Louisiana to be recognized as a top 50 children’s hospital by U.S. News & World Report for three consecutive years.Ochsner employs more than 26,000 employees and over 4,500 employed and affiliated physicians in over 90 medical specialties and subspecialties and conducts more than 700 clinical research studies. Ochsner Health System is proud to be a tobacco-free environment. For more information, please visit ochsner.org and follow us on Twitter and Facebook.