Transcatheter closure of patent ductus arteriosus in adults

• Published in: Postępy w kardiologii interwencyjnej Vol. 1; no. 2; p. 78
• Main Authors: Kepka, Cezary, Demkow, Marcin, Ruzyllo, Witold, Kowalski, Miroslaw, Dzielinska, Zofia, Ksiezycka, Ewa, Hoffman, Piotr
• Format: Journal Article
• Language: English; Polish
• Published: Poznan Termedia Publishing House 01-04-2005
• ISSN: 1734-9338; 1897-4295

Introduction: Surgical treatment of adults with patent ductus arteriosus (PDA) may require sternotomy and extracorporeal circulation. This can result in increased surgical risk as compared to infants and adolescents. We present the results of 10-year, single center experience with transcatheter closure of PDA in adults. Material and methods: Between 1993 and 2003 in 97 adults, aged 16-74 (mean 34.4), the procedure of thanscatheter closure of the PDA was performed. Three types of occluders were used: Rashkind double umbrella (group 1, 31 patients (pts)), detachable coil (group 2, 23 pts) and Amplatzer Duct Occluder (group 3, 43 pts). Mean minimal PDA diameter was 4.9, 2.2, and 6.1mm in group 1, 2 and 3, respectively. The choice of occluder type was dependent on type and diameter of PDA and on the period when the procedure was performed. Results: The procedure was successful in 93.3% (group 1), 92.3% (group 2) and 100% (group 3) of pts. The complete closure of PDA was achieved in 63% of pts in group 1 and 100% of pts in the remaining groups. Finally, at follow up (4-119 months) the ductus was occluded in 80% (group 1) and 100% (group 2, 3) of pts. No device fracture, dislodgement or thrombosis was observed. Conclusions: Our experience demonstrates that with the availability of detachable coils (narrow ducts) and Amplatzer Duct Occluder (wide ducts) any PDA can be closed regardless of its anatomy and diameter. Transcatheter procedures are safe and effective. The implantation of Rashkind double umbrella in adults results in unacceptable low rate of procedural success and unacceptable high rate of residual shunts.