Percutaneous closure of patent ductus arteriosus: short term results

Abstract

Objectives: To evaluate short term results of percutaneous patent ductus arteriosus (PDA) closure in a cohort of pediatric and adult patients following closure with the Amplatzer Ductal Occluder (ADO-1 and ADO-2) and Amplatzer Septal Occluder (ASO) devices. Study design: A total of 48 patients (17 male and 31 female; range 3 to 39 years) were included in this study. All patients were evaluated with transthoracic echocardiography (TTE) before intervention. Percutaneous closure was performed under fluoroscopy through anterograde or retrograde route. Aortagraphy was performed to measure and classify the ductus arteriosus. Residual shunt through ductus was controlled by aortography at the tenth minute and by TTE 24 hours and three months after the procedure. Results: The released device was ADO-1 in 25 patients (51.2%), ADO-2 in 22 patients (45.8%), and ASO in one patient. Mean follow-up was 13.2 months. In 97.9% of patients, the occluder was placed into the ductus without any complication. In one patient, the device embolized to the left pulmonary artery during implantation. Aortography performed ten minutes after the procedure showed complete closure in 38 patients without residual defect. TTE revealed trace amounts of residual shunt within the device in two patients, flow around the device in two patients 24 hours after implantation, and residual shunt in only one patient three month after intervention. Conclusion: Transcatheter closure of PDA with ADO-1 and ADO-2 devices has low morbidity and mortality with high rates of success in selected patients.

Keywords

• amplatzer occluder device
• ductus arteriosus
• patent/ therapy; echocardiography; heart catheterization; septal occluder device.