Transcatheter closure of the patient ductus arteriosus in adults using the Gianturco coil.
OBJECTIVE
Although results of surgical ligation of the patent ductus arteriosus (PDA) in the pediatric age group are excellent, surgical management of the adult with a PDA may be more problematic. The PDA that presents in adulthood may be calcified and friable, rendering simple ligation via a thoracotomy difficult, inadequate, and hazardous. Patch closure of the ductus arteriosus from either the aortic or pulmonary artery orifice using cardiopulmonary bypass or transient aortic cross-clamping is necessary but increases surgical risk. Furthermore, older patients with diseases unrelated to their PDA and patients with Down's syndrome may have higher risks with intubation, general anesthesia, and surgery. Early results of percutaneous transcatheter occlusion of the PDA with Gianturco coils performed under sedation and local anesthesia are promising.


METHODS
Six adults with mean age of 39.1 years (range 23.1-62.0 years) were found to have an isolated PDA with mean minimum diameter of 2.7 mm (range 1.0-5.0 mm) at cardiac catheterization. All underwent percutaneous transcatheter occlusion of the PDA using Gianturco coils.


RESULTS
Coil implantation was successful in all patients. There were no complications and all were discharged home within 24 hours. Complete ductal occlusion was seen immediately in 4 of 6 patients (67%) while 2 of 6 (33%) had small residual leaks. However, complete occlusion was achieved in all patients by 6 months following the procedure.


CONCLUSIONS
Transcatheter occlusion of the PDA using coils is safe and efficacious in adults.
Department of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston 77030, USA.
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Ing
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Mullins
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M
Rose
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Y
Shapir
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FZ
Bierman
D000328:Adult; D006328:Cardiac Catheterization; D004374:Ductus Arteriosus, Patent / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D016896:Treatment Outcome