Transcatheter patent ductus arteriosus occlusion: evolution of techniques and results from the 1990s.
OBJECTIVE
To review the evolution of transcatheter patent ductus arteriosus (PDA) occlusion techniques and results.


METHODS
A single institution, retrospective review including all patients with intention to close a PDA from 1991 to 1998, with no exclusions.


RESULTS
Rashkind occluder (n = 65), sideris double-button (n = 6), Cook detachable coil (n = 28) and Amplatzer ductal occluder (n = 4) were used. Successful implantation occurred in 99 of 103 patients. There was a need for a second transcatheter procedure to close residual ductal shunting in 12% of patients: Rashkind umbrellas (n = 8), double-button (n = 1), coils (n = 3). Eight patients (8%) required surgery, including 4 of 6 patients with the double-button occluder.


CONCLUSIONS
The Rashkind occluder and the Sideris double-button device both had an unacceptably high rate of residual shunts requiring a second transcatheter procedure or surgical closure. Detachable coils and the Amplatzer ductal occluder have become the current technology of choice for transcatheter PDA closure with high success rates.
O'Donnell
C
C
Department of Paediatric Cardiology, Green Lane Hospital, Auckland, New Zealand.
Neutze
J M
JM
Skinner
J R
JR
Wilson
N J
NJ
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome