title: Development of catheter-based treatment of patent ductus arteriosus: a medium-sized centre experience.
abstract: BACKGROUND
  Despite the availability of effective devices, percutaneous closure of patent ductus arteriosus (PDA) can be challenging in some situations.
  
  
  OBJECTIVE
  To describe our initial experience of percutaneous PDA closure.
  
  
  METHODS
  Between 2001 and 2007, 73 consecutive patients aged 3 months to 70 years underwent transcatheter PDA closure. An Amplatzer duct occluder (ADO) was chosen for ducts greater than 2 mm (n=50) and a Detachable coil (DC) for smaller ducts (n=23).
  
  
  RESULTS
  The diameter of the ducts ranged from 1 to 7.2 (mean 2.9+/-1.3) mm. The prostheses were implanted successfully in all patients. The complete closure rate reached 98% in the ADO group and 100% in the DC group at 12 months. Four (5.4%) patients showed asymptomatic device protrusion: three patients (5, 6 and 10 kg) into the aortic isthmus and one patient (7 kg) into the pulmonary artery (PA). One patient (7 kg) experienced transient severe bradycardia due to pulmonary air embolism. Another patient (3.3 kg) had a permanent asymptomatic occlusion of the femoral artery. In a third patient (17 kg), the ADO migrated asymptomatically into the descending aorta and was discovered 12 months later.
  
  
  CONCLUSIONS
  Even during the learning curve, percutaneous PDA closure can give excellent results. Strict adherence to protocols and careful follow-up assessments are mandatory. In small infants, the use of the ADO may lead to obstruction in the aorta or PA, or to device migration. Cautious surveillance for untoward events is essential, especially in small infants with large ducts.
authors.affiliation: Saint-Joseph university medical school, and Hôtel-Dieu de France hospital, Naccache boulevard, Beirut, Lebanon.
authors.forename: Zakhia
authors.initials: Z
authors.lastname: Saliba
authors.forename: Issam
authors.initials: I
authors.lastname: El-rassi
authors.forename: Dina
authors.initials: D
authors.lastname: Helou
authors.forename: Pauline
authors.initials: P
authors.lastname: Abou-Jaoudeh
authors.forename: Ghassan
authors.initials: G
authors.lastname: Chehab
authors.forename: Linda
authors.initials: L
authors.lastname: Daou
authors.forename: Daniele
authors.initials: D
authors.lastname: Khater
authors.forename: Bernard
authors.initials: B
authors.lastname: Gerbaka
authors.forename: Victor
authors.initials: V
authors.lastname: Jebara
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001027:Aortography; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D011474:Prosthesis Design; D016896:Treatment Outcome; D055815:Young Adult