[Transcatheter closure of persistent ductus arteriosus]

Abstract

Background: Transcatheter occlusion of persistent ductus arteriosus has replaced surgery as the treatment of choice. We wanted to evaluate the results of this treatment in our hospital.

Material and methods: From September 1989 through 2001, a total of 217 patients with persistent ductus arteriosus were scheduled for transcatheter occlusion at Rikshospitalet. Six ducts were too small for treatment. In the remaining 211 patients, 224 procedures were performed. Patients' median age was 3.4 years (range 4 months-82 years), their median weight 14 kilograms (range 4-90 kilograms).

Results: The Rashkind double umbrella was implanted successfully in 61/63 cases, coils in 99/102 cases, and an Amplatzer duct occluder in 57/59 cases. Complete closure of the duct was achieved in 197/211 patients (93%) after reintervention in 11. The complete occlusion rate for first procedures were 77% for the Rashkind device, 93% for coils and 100% for the Amplatzer plug. Only coils embolised, in 2 out of 102 procedures. Removed interventionally, they were replaced by an Amplatzer occluder. One patient developed haemolytic anaemia from residual shunting through a coil; the shunt and the anaemia both disappeared after implantation of a second coil.

Interpretation: Transcatheter occlusion of persistent ductus arteriosus is safe and efficient. The Amplatzer duct occluder seems superior to the Rashkind double umbrella and probably also to coils.