Guidewire and catheter manipulation without coil placement to close minimal patent ductus arteriosus.
BACKGROUND
Transcatheter coil closure (TCC) is safe and effective for most patients with PDA, but coil associated complications may occasionally be encountered. For occlusion of minimal PDA (<1 mm), we employed a closure protocol with guidewire and catheter manipulation.


METHODS
Between April 2000 and September 2004, 38 patients with a minimal PDA were classified into two groups according to the occlusion method at our institution. Group A consisted of 11 patients (age range 0.7 to 3.5 years; mean age 1.6 years) who underwent guidewire and catheter manipulation. Group B consisted of 27 patients (age range 0.5 to 2.7 years; mean age 1.3 years) who underwent TCC of PDA.


RESULTS
In group A (a PDA 0.4-0.9 mm), 9 (82%) patients had successful closure, and two (18%) patients failed the manipulation. No patient had complications during the procedure or follow-up. In group B (a PDA 0.5-0.9 mm), 26 (96%) patients had successful closure and 1 (4%) patient failed the attempt at TCC. No adverse events of coil closure was found during follow-up. Compared to the patients in group B, those in group A differed significantly in terms of procedure time. There were no significant differences in age, sex, body weight, PDA size, fluoroscopy time, success rate, and complication rate.


CONCLUSIONS
Our results indicate that the manipulation is safe and effective for patients with minimal PDA. The manipulation technique can be tried before TCC in patients with minimal PDA.
Department of Pediatrics, Veterans General Hospital-Kaohsiung, National Yang-Ming University, Taiwan.
Ken-Pen
KP
Weng
Chu-Chuan
CC
Lin
Shih-Ming
SM
Huang
Ta-Cheng
TC
Huang
Cheng-Liang
CL
Lee
Kai-Sheng
KS
Hsieh
D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D018618:Echocardiography, Doppler, Color; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome