Transcatheter Closure of the Patent Ductus Arteriosus

ABSTRACT

PURPOSE: Transcatheter closure of the patent ductus arteriosus(PDA) is a well-established, effective therapeutic modality, and many kinds of devices have been used to perform this closure. The aim of this study is to compare the effects of different kinds of devices. METHODS: We reviewed retrospectively the charts of 43 patients who were admitted to Kyung pook University Hospital between June 1995 and July 1998 to close PDA with many kinds of devices(Rashkind umbrella and duct occlud) through the catheter. We evaluated demographic factors, associated anomalies, cardiac catheterization data, types and sizes of PDA on cineangiocardiograms, implantation rates and complete closure rates. RESULTS: We were able to implant devices in 41(95.4%) out of the 43 patients. The patients were aged from 9 months to 28 years(rnedian 2.3 years), weighing from 8.0 to 71.8kg(median 14kg). There were 34 females and 9 males. Complications after procedure were hemolysis(3 cases, 7.3%) and mild left pulmonary artery stenosis(4 cases, 9.8%). Complete closure on aortic angiogram 15 min. after procedure were done in 26 cases(63.4%), 11/15(73.3%) with RU, 10/19(52.6%) with DC, and 5/8(62.55) with DO without significant differences. Serial complete closure rate with color flow Doppler study were 63.4%(26/41) at 1 week, 74.4%(29/39) at 3 months, 76.9%(30/39) at 6 months and 79.5%(31/39) at 12 months respectively. CONCLUSION: Catheter occlusion of small PDA is a very effective way of obviating the need for surgery, although further efforts will be needed to improve complete closure and reduce complications.