Early reopening and recanalization after successful coil occlusion of the patent ductus arteriosus.
BACKGROUND
Controversy exists regarding early reopening and recanalization after successful (complete) coil occlusion of the patent ductus arteriosus (PDA).


METHODS
Patients with successful PDA coil occlusion were reviewed with regard to PDA size and type, coil size, number of coils, and delivery technique. Follow-up echocardiograms at <24 hours, 6 months, and >12 months were reviewed for residual PDA shunt, left pulmonary artery (LPA) stenosis, and aortic obstruction.


RESULTS
Successful coil occlusion was achieved in 94 patients. On the initial (<24 hours) echocardiogram, 76 of 92 (83%) had complete PDA occlusion, 5 of 92 (5%) had mild LPA stenosis, and no patient had aortic obstruction. Follow-up at 6 months was available in 70 patients, 57 with complete occlusion on the initial echocardiogram. PDA reopening was found in 3 of 57 patients (5%). Larger PDA diameter was associated with residual shunt (2.40 +/- 0.40 mm versus 1.87 +/- 0.53 mm; P <.01). Disagreement between the initial and 6-month echocardiogram was found in 11 of 70 patients (16%). Intermediate follow-up (median, 30 months; range, 12 months to 5.3 years) was available in 46 patients, 38 with complete occlusion on the 6-month echocardiogram. No patient (0 of 38) with a normal echocardiogram at 6 months developed recanalization, LPA stenosis, or aortic obstruction.


CONCLUSIONS
These data suggest that: (1) routine echocardiography immediately after PDA coil occlusion is unnecessary; (2) early PDA reopening is uncommon; and (3) PDA recanalization does not occur if complete echocardiographic closure is documented 6 months after coil occlusion. Additional follow-up examination in these patients may not be necessary.
Turner
Daniel R
DR
Division of Cardiology, Children's Hospital of Michigan, and Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201-2196, USA. dturner@dmc.org
Forbes
Thomas J
TJ
Epstein
Michael L
ML
Vincent
Julie A
JA
D000293:Adolescent; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging* / Q000628:therapy; D004452:Echocardiography; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D012008:Recurrence; D015607:Stents; D013997:Time Factors