WIP 58 - Systemic Inflammation in Preterm Neonates with a Hemodynamically Significant PDA Undergoing Percutaneous Device Closure and its Association with Post-Ligation Cardiac Syndrome

Poster Number: WIP 58
Publication Number: WIP 58.792

Background: Hemodynamically significant patent ductus arteriosus (PDA) in preterm neonates is associated with significant morbidity and mortality. Pharmacological closure is frequently unsuccessful, necessitating definitive interventional closure. The abrupt change in loading conditions to the heart from interventional closure can lead to cardiovascular and respiratory instability, an entity termed post-ligation cardiac syndrome (PLCS). Intriguingly, PLCS following percutaneous device closure appears to present as a different clinical phenotype from surgical ligation and may be associated with increased markers of inflammation as was shown recently in older infants, despite less hemodynamic compromise. Our center is uniquely positioned to investigate the consequences of percutaneous PDA closure with extensive experience investigating the neonatal inflammatory cascade as well as expertise in targeted neonatal echocardiographic (TnEcho) hemodynamic assessments.

Objective: To investigate inflammatory cytokines in neonates following percutaneous PDA device closure and their association with hemodynamic markers and development of PLCS.

Design/Methods: This is a retrospective analysis of infants born < 27 weeks from 2021-2023 including (1) the intervention group who underwent percutaneous device closure and either did or did not develop PLCS (n=19) and (2) a control group who had spontaneous PDA closure. All infants were cared for at the University of Iowa < and received frequent TnEchos assessments. For the intervention group, serum was collected 7  2 days prior to and 1-3 days following percutaneous closure. For the control group, serum was collected at the average time of PDA closure in the intervention group (postnatal day 28). A multiplex protein assay will be performed measuring IL-1, IL-6, IL-8, IL-10, IL-12p70, MCP-1, PDGF, TNF-, and VEGF. These will be compared against the development PLCS as well as TnEcho hemodynamic measures. This study has received IRB approval. Serum and TnEcho assessments have been collected, data analysis will take place over the next 2 months.