Percutaneous closure of small patent ductus arteriosus: comparison of Rashkind double-umbrella device and occluding spring coils.
We compared our current practice of closing small patent ductus arteriosus (PDA) with coils with our previous experience of using double-umbrellas. Twelve patients underwent percutaneous closure of a small PDA with a coil. Selection criteria were a minimal diameter of < or = 2.5 mm and angiographic type A or E. The 12 most recent, non-consecutive patients who had undergone double-umbrella device closure of a PDA and would presently be considered suitable candidates for spring coil occlusion were retrospectively reviewed. The two groups were compared with regard to complications and immediate and midterm results. Eleven of the 12 attempted PDA occlusions using spring coils were successful. The mean follow-up period was 5.8 +/- 4.6 months. Color-Doppler echocardiograms have shown no residual leaks, no turbulence in the descending aorta, and no left pulmonary artery stenosis. All 12 attempted double-umbrella device placements were successful. The mean follow-up period was 16.2 +/- 5.8 months. Color-Doppler echocardiograms have shown trivial residual leaks in four patients and mild turbulent flow in the left pulmonary artery in one patient. There was no significant difference between the two groups in demographic and hemodynamic data. Although the mean follow-up time was significantly longer in the patients who underwent double-umbrella closure, there was significantly more color-Doppler echocardiographic evidence of residual flow (P < 0.03). Small PDA closure with coils is effective, resulting in less residual leaks compared with the double-umbrella device.
Zeevi
B
B
Institute of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
Berant
M
M
Bar-Mor
G
G
Blieden
L C
LC
D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D004864:Equipment and Supplies; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications