Comparison and results of transcatheter closure of patent ductus arteriosus using the swivel-disk device versus plug occluder in children.
The transcatheter closure of certain types of patent ductus arteriosus (PDA) remains a challenge. The investigators report initial clinical experience with 25 patients who underwent PDA occlusion with the use of a swivel-disk device (SDD) or a plug occluder (PO). The patients were divided into 2 groups: in the SDD group, 12 patients aged 1 to 2 years with type A PDA underwent attempted closure using the SDD, a modified Amplatzer duct occluder with a very low profile retention disk that can adapt itself at different PDA insertion angles. The mean PDA diameter was 4.8 +/- 1.5 mm (range 3.8 to 8). In the PO group, 13 patients aged 0.5 to 3 years with type C, D, or E PDA underwent attempted occlusion with the PO, a tubular occluder made of Nitinol wire mesh. The mean PDA diameter was 4.2 +/- 3.5 mm (range 1.2 to 9). The 2 occluders are filled with Dacron patches. The mean device diameters were 6.5 +/- 1.2 and 6.8 +/- 2.2 mm (range 4 to 11) in the SDD and PO groups, respectively. Complete angiographic closure was seen in 24 of 25 patients. The deployment of 4 5-PDA5 coils abolished a residual shunt associated with hemolysis in a 5-month-old patient with a large type C PDA after the implantation of an 11-mm PO. No other complications were observed. In conclusion, the SDD and the PO are promising additions to the armamentarium for PDA closure.
Thanopoulos
Basil Vasilios D
BV
Department of Pediatric Cardiology, Aghia Sophia Children's Hospital, Athens, Greece. thanopoulos.d@gmail.com
Tzannos
Konstantinos A
KA
Eleptherakis
Nikolaos
N
Stefanadis
Christodoulos
C
D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D002675:Child, Preschool; D017023:Coronary Angiography / Q000295:instrumentation; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome; D014463:Ultrasonography