Transcatheter occlusion of the patent ductus arteriosus in the presence of mild isthmal hypoplasia.
Between January 1990 and February 1992, 5 asymptomatic patients were identified with hypoplasia of the aortic isthmus at the time of cardiac catheterization for closure of a small patent ductus arteriosus. Isthmal diameters measured from lateral aortograms were 62 +/- 11% of age-matched controls. All patients had a small communication occluded with a 12 mm device and remained asymptomatic at 6-30 months follow up. Residual shunting was demonstrated by color Doppler in 2 patients. No child has developed an arm-leg systolic blood pressure gradient or systemic hypertension. Following device placement, Doppler interrogation across the isthmus in 2 patients demonstrated a velocity shift of 2.1 m/s. Transcatheter occlusion of the patient ductus arteriosus associated with mild isthmal hypoplasia of the aortic arch appears safe and effective and does not result in a clinically significant impairment to isthmal flow in short-term follow-up.
Nykanen
D G
DG
Department of Pediatrics, Hospital for Sick Children, Toronto, Canada.
Hayes
A M
AM
Benson
L N
LN
Freedom
R M
RM
D001017:Aortic Coarctation / Q000175:diagnosis / Q000628:therapy*; D001027:Aortography; D006328:Cardiac Catheterization; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000628:therapy*; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies