ABSTRACT
Percutaneous closure of patent ductus arteriosus [PDA] is done in the cardiac catheterization laboratory, usually under fluoroscopic and angiographic guidance. The aortogram is used for assessing PDA size and shape the pre-device implantation. Additionally, post-device aortograms are applied for the assessment of device position, profile and residual shunt. Angiograms expose patient to radiation and possible untoward effects of contrast media. Recently, transthoracic echocardiography has been utilized to guide in PDA closure to avoid radiation exposure as well as contrast material. On two occasions, we were obligated by special circumstances to close the PDA under echocardiography guidance. First case was a 6-month baby girl with mild signs of heart failure having moderate size PDA. She underwent device closure under transthoracic echocardiogram as the angiographic system had stopped working during the procedure. Second case was a 6-year girl, weighting 16-kg with chronic renal failure. She had moderate size PDA closed by device under transthoracic echocardiographic, guidance avoiding the use of contrast agent due to chronic renal failure