Nonsurgical Closure of Oversized Patent Ductus Arteriosus with Pulmonary Hypertension

Abstract

Safe and permanent closure of patent ductus arteriosus (PDA) can be accomplished with an ivalon plug introduced by catheterization from the femoral artery. The authors' experience thus far obtained from treating more than a hundred patients suggests that the technique described in this paper is a feasible alternative to the surgical approach. A prerequisite has been the size and shape of the PDA, the lumen of which had to be conical in shape and smaller than the lumen of the femoral artery. Now safe closure of oversized PDA complicated by pulmonary hypertension has become possible, using a plug designed with a special mechanism for anchorage to the PDA. The technique of this closure is described in detail in this report of its successful use in a 50-year-old woman patient with an oversized, calcified PDA complicated by pulmonary and systemic hypertension and cystic lung disease. Treating such high-risk cases with transfemoral closure means real improvement in therapy over surgical treatment.

Transesophageal echocardiography-guided percutaneous patent ductus arteriosus closure without fluoroscopy

“…Open surgery generally has a large surgical incision affecting the appearance and chest development in children. Porstmann et al [ 8 ] was the first to consider using percutaneous interventional therapy and achieved success in 1967. So far, closure under fluoroscopy guidance has been widely performed [ 9 , 10 ].…”

Transvenous embolization using the Amplatzer Vascular Plug II in patent ductus arteriosus concomitant with Stanford type B aortic dissection: A case report

“…Porstmann et al performed the first transcatheter closure of PDA in 1967, which has remained the preferred treatment of choice to date, owing to its advantages of minor trauma and shorter recovery time. [12,13]…”

Closure of the calcified patent ductus in adults—a new surgical method for interruption of the patent ductus

“…Moreover, there may be hyperperfusion damage to the lung circulation if the left-to-right shunt from the ductus prolongs the total cardiopulmonary bypass time. Porstmann et al [7] developed closure of the patent ductus with ivalon sponge plugging through a catheter technique, even in a case of oversized patent ductus with pulmonary hypertension. The original method was modified but still requires well-experienced technique on the part of the cardiologist.…”