Complications after transcatheter closure of patent ductus arteriosus

Abstract

To evaluate the short- and mid-term results and complications ensuing the transcatheter closure of patent ductus arteriosus (PDA). Between October 1999 and December 2005, 117 patients (34 males and 83 females) underwent attempted percutaneous closure of PDA with a minimum diameter of more than 3 mm. Follow-up evaluations were conducted at 1 day and 1, 3, 6, 12 months after the performance of the transcatheter closure. The median age of patients at catheterization was 11 yr (range, 0.6 to 68 yr), median weight was 30 kg (range, 6 to 74 kg), and the median diameter of PDA was 4 mm (range, 3 to 8 mm). This procedure was conducted successfully in 114 patients (97.4%), using different devices. Major complications were detected in 4 patients (3.4%); significant hemolysis (2), infective endocarditis (1), failed procedure due to embolization (1). Minor complications occurred in 6 patients (5.1%); mild narrowing of the descending aorta (2) and mild encroachment on the origin of the left pulmonary artery (4). Although the transcatheter closure of PDA may be considered to be effective, several complications, including hemolysis, embolization, infective endocarditis, and the narrowing of adjacent vessels may occur in certain cases.

Fig. 1

Distribution of cases by year.

Fig. 2

(A) Lateral aortogram showing a patent ductus arteriosus, 8 mm in diameter. (B) Lateral aortogram after implantation of a 12/10 mm Amplatzer ductal occluder showing trivial residual flow in the pulmonary artery.

Fig. 3

Aortogram in lateral (A) and right anterior oblique view (B) displaying a large patent ductus arteriosus, 5 mm in diameter. Aortograms in lateral (C) and right anterior oblique view (D) after implantation of a 10/8 mm Amplatzer ductal oceluder show the protrusion of the retention disc into the aortic lumen.

Fig. 4

A quantitative lung perfusion scan after deployment of a 10/8 mm ADO shows a decreased perfusion of the left lung. ANT, anterior.

Fig. 5

(A) Transthoracic echocardiography shows the protrusion of the device (arrow) into the aortic lumen. (B) Doppler echocardiography in descending aorta shows a peak velocity of 1.6 m/sec.