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KMID : 1130320090520040488
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Korean Journal of Pediatrics
2009 Volume.52 No. 4 p.488 ~ p.493
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A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices
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Kim Sang-Yee
Sul Jun-Hee
Kim Nam-Kyun
Choi Jae-Young
Lee Soo-Hyun
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Abstract
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Purpose: The aim of this study was to assess the efficacy and safety of recent-generation patent ductus arteriosus (PDA) closure devices applied by a new selection strategy according to the characteristics of each PDA.
Methods:From February 2003 to January 2006, 138 patients underwent transcatheter closure of PDA (study group). According to the size and morphology of each ductus, a COOK Detachable Coil or "flex" PFM Nit-Occlud was used for a small ductus (group 1, n=43); "medium" PFM Nit-Occlud (group 2, n=49) for a moderate ductus; and an Amplatzer Duct Occluder (group 3, n=46) for a large ductus. The 83 patients who underwent transcatheter closure of PDA from February 2000 to January 2003 were defined as the comparison group. The Qp/Qs ratio, pulmonary/aorta pressure ratio, and MD of the ductus were compared. Immediate and follow-up results including residual shunts and complications were also evaluated and compared among groups.
Results: In all 138 patients, complete occlusions were confirmed without major complications, while procedure failure (n=2, 2.2%), device embolization (n=1, 1.1%), and persistent residual shunt (n=4, 4.5%) were documented in the comparison group. Total complication rates were lower in the study group than in the comparison group (study group, 1.4%; comparison group, 9.0%; P<0.05).
Conclusions: A novel strategy adopting the merits of various recent-generation devices for transcatheter closure of PDA provides excellent clinical results with minimal risk.
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KEYWORD
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Ductus Arteriosus, Patent, Cardiac Catheterization, Devices
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