Lung perfusion studies after detachable coil occlusion of persistent arterial duct.
OBJECTIVE
To evaluate relative lung perfusion following complete occlusion of persistent arterial duct with detachable Cook coils.


METHODS
Ductal occlusion using detachable coils was performed in 35 patients (median age 3.9 years, range 0.5 to 16; 32 native ducts, three patients with previous devices). If the duct could be crossed with a 0.035 inch guidewire and a 4 F catheter after coil implantation, a further coil was implanted. Between one and seven coils were used (median two).


RESULTS
Complete ductal occlusion was confirmed by echocardiography 24 hours after the procedure in all patients. Lung perfusion scans were performed three months after the procedure in 33 of 35 patients (two older patients with a single coil each did not attend). Decreased perfusion to the left lung (defined as < 40% of total lung flow) was observed in only one patient, who had previously had a 17 mm Rashkind umbrella implanted. There was no correlation between left lung perfusion and peak left pulmonary artery Doppler velocities (r = 0.27 and p = 0.125 for the entire group; r = 0.29 and p = 0.124 after excluding patients with previous devices).


CONCLUSIONS
Coil occlusion is effective in achieving complete closure of the duct. An aggressive approach using multiple coils did not compromise perfusion to the left lung.
Sreeram
N
N
Department of Cardiology, Wilhelmina Children's Hospital, ABC Straat, 3501 CA Utrecht, Netherlands. nsreeram@azu.ruu.nl
Tofeig
M
M
Walsh
K P
KP
Hutter
P
P
D000293:Adolescent; D001783:Blood Flow Velocity; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000628:therapy*; D015150:Echocardiography, Doppler; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011652:Pulmonary Circulation; D011877:Radionuclide Imaging; D015607:Stents