title: Percutaneous closure of recanalised ductus arteriosus--a single-centre experience.
abstract: 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.
authors: Oddział Wrodzonych Wad Serca i Kardiologii Dzieci, Slaskie Centrum Chorób Serca, ul. Szpitalna 2, 41-800 Zabrze. jkusa@poczta.onet.pl
authors: Jacek
authors: J
authors: Kusa
authors: Małgorzata
authors: M
authors: Szkutnik
authors: Jacek
authors: J
authors: Baranowski
authors: Eloa
authors: E
authors: Adams
authors: Blandyna
authors: B
authors: Karwot
authors: Jarosław
authors: J
authors: Rycaj
authors: Ireneusz
authors: I
authors: Haponiuk
authors: Jacek
authors: J
authors: Białkowski
mesh_terms: 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