Clinical outcome of transcatheter closure of patent ductus arteriosus in small children weighing 10 kg or less

Abstract

PurposeTranscatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center.MethodsBetween January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable Coil®, PFM Nit-Occlud®, or Amplatzer duct occluder®. A retrospective review of the treatment results and complications was performed.ResultsThe mean age of patients was 9.1±5.9 months (median, 8 months), and mean weight was 7.6±1.8 kg (median, 7.8 kg). The mean diameter of PDA was 3.2±1.4 mm (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was 3.0±3.3 days, and mean follow-up duration was 21.0±19.6 months. There were no major complications in any of the patients.ConclusionTranscatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.

Long‐term follow‐up is not indicated after routine interventional closure of persistent arterial ducts

“…No pathology developed at any later stage. This confirms the result of a smaller study of Park et al . Interestingly, Sreeram et al suggested that the use of echocardiogram was an unreliable screening method for decreased flow in left pulmonary artery, and that its stenosis is a rare complication especially with the use of multiple coils .…”

“…Percutaneous occlusion of a patent ductus arteriosus (PDA) with coils or occlusive devices is effective and the method of choice outside the neonatal period . Potential adverse effects of the intervention include device‐related obstruction to flow in the left or right pulmonary arteries or descending aorta, persistent shunting past the device with potential subsequent haemolysis, and device migration.…”

Transcatheter closure of patent ductus arteriosus in children weighing 5 kg or less: Initial experienc

“…We used Amplatzer Duct Occluder (ADOI) in 11 cases, Amplatzer duct Occluder (ADOII) in 4 cases and only one PDA was closed with Amplatzer Duct Occluder (ADOIIAS). The results documented in our series are in accordance with theresults reported by other interventional paediatric cardiac centres [6,[17][18][19]22].…”

“…Pediatric Review: International Journal of Pediatric Research Available online at: www.medresearch.in 250|P a g e closure of PDA in children weighing 5 kg or less. In a previous report by Park et al [17], the median age of 115 patients was 8 months and mean body weight was 7.8kg while in our study median age was 6 months and median weight was 3.2 kg.…”

Early clinical experience with the new Amplatzer Ductal Occluder II for closure of the persistent arterial duct

“…Transcatheter closure procedures have been performed with high success rates both in children and adults [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] . Due to advances in diagnostic and therapeutic modalities diagnosis and treatment of PDA can be accomplished at a relatively early age [5][6][7] .…”