Percutaneous closure of recanalised ductus arteriosus--a single-centre experience.
BACKGROUND
Restoration of blood flow through a previously occluded ductus arteriosus may occur in some patients. Treatment strategy in patients with such residual shunts has not yet been uniformly established.


OBJECTIVE
To present single-centre experience and to attempt to establish a strategy of management of patients with residual ductus arteriosus shunts following percutaneous closure.


METHODS
Of 352 patients who underwent percutaneous closure of ductus arteriosus, in 13 subjects complete closure failed (coils and Rashkind occluders were used in 10 and 3 patients, respectively). In these patients other percutaneous interventions aiming at total closure of residual shunt were attempted.


RESULTS
In 12 patients coils were inserted (one patient received two coils). Introduction of implant in one patient failed, but total occlusion of the shunt was confirmed one day after the procedure. Trivial residual shunt was observed in one patient after one-year follow-up.


CONCLUSIONS
Percutaneous treatment of residual shunts within the ductus arteriosus is an effective and safe procedure. In our opinion identifying and treating such leaks is important, as it prevents complications and long-term need for antibiotic prevention of infective endocarditis. In the case of a small residual shunt, insertion of a coil seems to be the optimal therapy due to the low cost of the device, favourable design and high effectiveness. For patients in whom anatomy of the ductus arteriosus has been significantly changed, particularly in previously treated subjects, techniques using vascular loops or insertion using a catheter wedge may be helpful.
Kusa
Jacek
J
Oddział Wrodzonych Wad Serca i Kardiologii Dzieci, Slaskie Centrum Chorób Serca, ul. Szpitalna 2, 41-800 Zabrze. jkusa@poczta.onet.pl
Szkutnik
Małgorzata
M
Baranowski
Jacek
J
Adams
Eloa
E
Karwot
Blandyna
B
Rycaj
Jarosław
J
Haponiuk
Ireneusz
I
Białkowski
Jacek
J
D000293:Adolescent; D001027:Aortography; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D012086:Reoperation; D016896:Treatment Outcome