title: Does ductal occlusion with the gianturco coil cause left pulmonary artery and/or descending aorta obstruction?
abstract: Thirty-two patients (median age 4.5 years) underwent transcatheter Gianturco coil occlusion of a patent ductus arteriosus. Transthoracic echocardiography was performed the day after coil placement and at intermediate follow-up (median 8.6 months). Echocardiographic results were compared with angiographic and hemodynamic data obtained during catheterization. Two-dimensional (2D) echocardiography performed the day after ductal occlusion displayed evidence of coil protrusion into the left pulmonary artery in 28 of 31 patients (90%) and into the descending aorta in 17 of 29 (59%). However, pulsed Doppler analysis demonstrated normal left pulmonary arterial flow velocities in 28 of 29 patients (97%) and normal descending aortic flow velocities in 26 of 27 (96%). Pulse Doppler results were corroborated by angiographic and hemodynamic catheterization data, which showed no evidence of adjacent vessel obstruction. Peak Doppler velocities among patients with and without 2D echocardiographic left pulmonary artery or descending aorta coil impingement did not differ significantly. The discrepancy between 2D and pulse Doppler findings did not change significantly at intermediate follow-up. Thus, transcatheter occlusion of the patent ductus arteriosus with properly implanted Gianturco coils does not cause significant obstruction to flow in the left pulmonary artery or descending aorta despite frequently misleading 2D echocardiographic images of coil impingement on these vessels.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.
authors.forename: D
authors.initials: D
authors.lastname: Stromberg
authors.forename: R
authors.initials: R
authors.lastname: Pignatelli
authors.forename: G L
authors.initials: GL
authors.lastname: Rosenthal
authors.forename: F F
authors.initials: FF
authors.lastname: Ing
mesh_terms: D000293:Adolescent; D000328:Adult; D000792:Angiography; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000628:therapy*; D015150:Echocardiography, Doppler; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012189:Retrospective Studies