Transcatheter Ductus Arteriosus Closure with Various Devices in the Pediatric Patient Group and Long-term Outcomes: Experience from a Single Center

Abstract

Aim: The emergence of advanced duct occluder devices has made transcatheter patent ductus arteriosus (PDA) closure the preferred treatment for pediatric patients. This study compared the effectiveness, safety, and long-term outcomes of various transcatheter PDA closure devices. Materials and Methods: This study involved 320 patients aged 0 to 18 years who underwent transcatheter PDA closure at our hospital from 2004 to 2023. We retrospectively reviewed their records in order to assess procedure success, demographic information, clinical features, angiographic parameters, and complications. Patients were categorized by closure type: Group I for coil closure, Group II for Amplatzer Duct Occluder (ADO)-I closure, and Group III for ADO-II closure. Results: In this study of 320 patients, 203 (63.4%) were female and 117 (36.4%) male. The average age was 56.5 months (±49.6), with a median weight of 15 kg (interquartile range 10.5-23 kg). The median diameter of the PDA at its narrowest point was 2.0 mm (interquartile range 2-3 mm). Ductal anatomy distribution was as follows: Type A (176 patients, 55%), type B (49 patients, 15.3%), type C (30 patients, 9.3%), type D (5 patients, 1.56%), type E (57 patients, 17.8%), and type F (4 patients, 1.25%). Arterial access was used in 263 patients (82.1%), and venous plus arterial access in 57 patients (17.8%). Closure techniques included the ADO-II in 107 cases (33.4%), ADO-I in 12 cases (3.75%), and coils in 201 cases (62%). The early closure rate was 97.5%, with initial shunt rates of 0.6% and 0.3% at one month. Device embolization occurred in 5 patients (1.87%). By the six-month follow-up, all PDAs had closed, resulting in an overall transaction success rate of 97.5%. The average follow-up period was 105.8±55 months. Conclusion: Percutaneous closure of PDA in children is safe and effective, with a high success rate. Key factors include the patient’s age, weight, duct dimensions, and the type and size of the PDA. ADO-I devices are ideal for larger defects, while coil or ADO-II devices are preferable for smaller ones. Proper patient selection is critical for successful outcomes.

Keywords

• children
• patent ductus arteriosus
• percutaneous pda closure
• pda closure devices