title: Do we need a femoral artery route for transvenous PDA closure in children with ADO-I?
abstract: OBJECTIVE
  The standard procedure in percutaneous closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder-I (ADO-I) is transvenous closure guided by aortic access through femoral artery. The current study aims to compare the procedures for PDA closure with ADO-I: only transvenous access with the standard procedure.
  
  
  METHODS
  This study was designed retrospectively and 101 pediatric patients were included. PDA closure was done by only femoral venous access in 19 of them (group 1), arterial and venous access used in 92 patients (group 2) between 2004 to 2012 years. The position of the device and residual shunt in group1 was evaluated by the guidance of the aortogram obtained during the return phase of the pulmonary artery injection and guidance of transthoracic echocardiography. Shapiro-Wilk's test, Mann-Whitney U, chi-squared tests were used for statistical comparison.
  
  
  RESULTS
  The procedure was successful in 18 (95%) patients in group 1 and 90 (98%) patients in group 2. Complications including the pulmonary artery embolization (n=1), protrusion to pulmonary artery (n=1), inguinal hematoma (n=3), bleeding (n=2) were only detected in group 2. In other words, while complications were observed in 7 (7.2%) patients in group 2, no minor/major complication was observed in group 1. Complete closure in group 1 was: in catheterization room 14 (77.8%), at 24th hour in 2 (11.1%), at first month in 2 (11.1%). Complete closure in group 2 was: 66 (73.4%) patients in the catheterization room, 21 (23.3%) at 24th hour, 3 (3.3%) at first month, complete closure occurred at the end of first month.
  
  
  CONCLUSIONS
  In percutaneouse PDA closure via ADO-I, this technique can be a choice for patients whose femoral artery could not be accessed, or access is impossible/contraindicated. But for the reliability and validity of this method, randomized multicenter clinical studies are necessary.
authors.affiliation: Department of Peadiatric Cardiology, Faculty of Medicine, Erciyes University; Kayseri-Turkey. duruozyurt@yahoo.com.tr.
authors.forename: Ali
authors.initials: A
authors.lastname: Baykan
authors.forename: Nazmi
authors.initials: N
authors.lastname: Narin
authors.forename: Abdullah
authors.initials: A
authors.lastname: Özyurt
authors.forename: Mustafa
authors.initials: M
authors.lastname: Argun
authors.forename: Özge
authors.initials: Ö
authors.lastname: Pamukçu
authors.forename: Sertaç H
authors.initials: SH
authors.lastname: Onan
authors.forename: Sadettin
authors.initials: S
authors.lastname: Sezer
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Baykan
authors.forename: Kazım
authors.initials: K
authors.lastname: Üzüm
mesh_terms: D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D017023:Coronary Angiography; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D055989:Septal Occluder Device; D016896:Treatment Outcome