Transcatheter coil occlusion of patent ductus arteriosus.

Between May 1995 and October 1997, 17 cases of small patent ductus arteriosus (PDA) underwent percutaneous coil occlusion at the Department of Pediatrics, Chulalongkorn Hospital. The mean age was 5.3 +/- 3.6 years (range, 1 year 4 months to 12.0 years); mean weight was 18.9 +/- 11.7 kg (range, 9 to 48 kg). The mean minimum diameter of the PDA was 2.8 +/- 0.6 mm (range, 1.7 to 4.0 mm). PDA occlusion was achieved with one coil in 9 patients and two coils in 8 patients. One patient required the second coil occlusion procedure to occlude the residual PDA leakage. Of the 17 patients, coils were successfully implanted in 15 patients: complete closure of PDA was obtained in 14 patients, confirmed by aortography or by color flow echo imaging or both. In the two unsuccessful coil implantation cases, coils migrated to the distal left pulmonary artery (1 case) and the distal right pulmonary artery (1 case). They could not be retrieved. Both patients had surgical closure of PDA on the following day after the failed procedure. No clinical and chest X-ray showed any evidence of pulmonary complication from the migrated coils up to 1-year follow-up. PDA coil occlusion provides an alternative to surgical closure. The procedure is safe and has a good result.

Successful modified Norwood operation for hypoplastic left heart syndrome in neonatal period: the first reported case in Thailand.

We report a neonatal patient with hypoplastic left heart syndrome on whom Modified Norwood operation was performed when she was 21 days old. The details of the operative technic and postoperative care were presented. Her growth and development at 6 months after operation was in normal range. This is the first successful modified Norwood operation for hypoplastic left heart syndrome in the neonatal period in Thailand.