Transcatheter closure of patent ductus arteriosus, evaluating the outcome; single center experience in Mansoura, Egypt

Abstract

Introduction: Device closure is the treatment of choice for patent ductus arteriosus (PDA). Different types of occlusion devices have been developed. We tried to evaluate the outcome in a single tertiary center country through analyzing the immediate and short-term outcomes of transcatheter occlusion in patients with PDA using three different devices. Methodology: Between January 2008 and December 2015, 213 pediatric patients with PDA underwent PDA occlusion. Aortic angiography was done to evaluate the size, position, and shape of the duct for proper device selection. A second aortic angiography was performed ten minutes after device deployment. Echocardiography was repeated at intervals of 24 h, then at one, three, six and 12 months after the procedure to assess the presence of any complications. Results: The results were assessed by angiography and echocardiography. The mean age was 9.2 ± 5.2 months and their mean weight was 7.6 ± 1.8 kg. Mean PDA diameter at its narrowest point measured by angiography was 2.81 ± 0.51 mm. Nit-Occlud pfm Coil occlusion was performed in 107 patients, ADO-I was performed in 39.4% and Nit-Occlud PDA-R was performed in 10.3%. Complete closure was observed in 95.7% of the patients prior to discharge and this rate has reached 98.5% after 3 months period of follow up and increased to 100% at 6 and 12 months visits. Conclusion: Transcatheter closure of PDA technique using Nit-Occlud pfm coils, Nit-Occlud PDA-R and Amplatzer ductal occluder proved to be safe and effective. The residual leak was minimal in our series.