title: Transcatheter patent ductus arteriosus occlusion: application in the small child.
abstract: OBJECTIVE
  This study intended to evaluate application of transcatheter occlusion of the patent ductus arteriosus in children < 10 kg body weight.
  
  
  BACKGROUND
  Transcatheter occlusion of the patent ductus arteriosus in the child weighing > 10 kg has been proved safe and effective.
  
  
  METHODS
  We reviewed 74 consecutive patients weighing < 10 kg (median 8.1 kg, range 3.98 to 10) and aged 4 to 30 months (median 13 months) who underwent patent ductus arteriosus occlusion between June 1986 and November 1992. A modification of the delivery system to facilitate application in small children is described.
  
  
  RESULTS
  A 12-mm device was implanted in 50 patients and a 17-mm device in 24. Three device embolizations occurred early in the experience, and one required removal because of hemolysis associated with a moderate residual shunt. One 17-mm device was removed at catheterization because of acute compromise to left pulmonary artery flow after implantation. Prevalence of residual shunting was 33% at 6 months, 20% at 12 to 18 months and 17% at 2-year follow-up and was not related to device, age, weight or size of the patent ductus. Altered flow to the left pulmonary artery was noted in seven patients (9.9%), with more significant compromise associated with the 17-mm device.
  
  
  CONCLUSIONS
  Transcatheter patent ductus arteriosus occlusion is feasible in the small child < 10 kg, particularly with the use of a modified delivery system. However, implantation of a 17-mm device in this patient population may impair flow to the left lung and should be reserved for the symptomatic child.
authors.affiliation: Department of Pediatrics, University of Toronto Faculty of Medicine, Ontario, Canada.
authors.forename: D G
authors.initials: DG
authors.lastname: Nykanen
authors.forename: A M
authors.initials: AM
authors.lastname: Hayes
authors.forename: L N
authors.initials: LN
authors.lastname: Benson
authors.forename: R M
authors.initials: RM
authors.lastname: Freedom
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000503:physiopathology