Transcatheter closure of residual patent ductus arteriosus shunting after the Rashkind occluder device using single or multiple Gianturco coils.
Transcatheter closure of a patent ductus arteriosus (PDA) using the Rashkind occluder or the buttoned device is accompanied with a 7-38% incidence of residual shunt. Closure of the residual shunt with a second device is expensive, associated with possible morbidity, can be technically challenging, and occasionally does not completely eliminate the shunt. Our objective was to assess the immediate and short-term results of transcatheter closure of residual PDA after the Rashkind device using single or multiple Gianturco coils. Five patients (one male/four female) underwent transcatheter closure of residual PDA at a median age of 8.4 yr (range 2-10.1 yr) and median weight of 23 kg (range 11.8-32 kg). A 4F catheter was used for delivery of the coils in all patients. Three patients underwent multiple coil and two single coil closure with complete elimination of the shunt. There was complete elimination of the shunt as documented by repeat angiography immediately after the coil closure. The median fluoroscopy time was 24 min (range, 22-55 min). All patients were discharged home on the same day. There were no complications Follow-up evaluation was performed with color flow mapping of the main pulmonary artery within 4 hr after closure and 6 weeks later with echocardiography and chest radiography. We conclude that transcatheter closure is an effective therapy for patients with residual PDA after the Rashkind device using the single or multiple coil technique. This technique can be performed on an out-patient basis without the need for general anesthesia and at a lower expense than a repeat occluder device or surgery.
Department of Pediatrics, Floating Hospital for Children at New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
Z M
ZM
Hijazi
R L
RL
Geggel
F
F
al-Fadley
D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D011859:Radiography