Transcatheter occlusion of residual shunt after interventional therapy of patent ductus arteriosus / 中国介入心脏病学杂志

ABSTRACT

Objective To explore the feasibility and efficacy of transcatheter closure of residual shunts after interventional therapy of patent ductus arteriosus (PDA). Methods A total of 16 patients (12 females, 4 males) with residual shunt after the first interventional therapy underwent transcatheter closure of residual shunt using different devices by arterial or venous route from March 1997 to August 2001. The median age was 5.9 years (range 2-9 years) and median weight was 17.7 kg (range 9-28 kg). The mean interval between the first procedure and the second procedure was 1.5 years (range 1 d-3.5 yr). Results The median minimal diameter of residual shunt was 2.7 mm (1.2-5.0 mm). Transcatheter occlusion was successfully performed in 15 patients and the success rate reached to 94% (15/16). Eleven Cook detachable coils, two Amplatzer Duct Occluders (ADO), one Sideris device, and two Rashkind devices were placed in 9 (two coils in 2 patients), 2, 1, and 2 patients respectively. One Sideris device and one Cook detachable coil were placed in one patient simultaneously. The complete occlusion rate of the residual shunts was 80% (12/15) assessed by angiography immediately. The mean procedure time was 75 min (45-120 min) and the mean fluoroscopy time was 10.4 min (5-20 min). All residual shunts were found to be completely closed 24 h after the procedure by echocardiography. Complication was encountered in one patient with loss of the pulse of the femoral artery. There were no device migration and pulmonary arteries obstruction in all patients at mean 2 years follow-up. Conclusion Transcatheter closure of residual shunt after the first interventional therapy is a feasible, effective alternative of surgical procedure.