GP23 Percutaneous closure of patent ductus arteriosus: single center experience

Abstract

Aim In this study, we aimed to evaluate our clinical experiences in the percutaneous closure of patent ductus arteriosus (PDA) in the pediatric population with our early and late results. Method A total of 156 patients who underwent percutaneous PDA closure between March 2004 and January 2018 were included in the study. Clinical, echocardiographic and angiographic findings of patients, characteristics of procedures, complications, early and late results were evaluated. Results The mean age of patients undergoing PDA closure was 4.5 ± 4 years (1.5 months-17 years), with an average weight of 17.8 ± 12.1 kg (2.3–68 kg). The PDA type was conical in 117 (75%) patients, tubular in 34 (21.7%), window type in 4 (2.5) patients and complex in 1 (0.6%) patient. In 150 (96.1%) patients, the procedure was successful, PDA was closed in 43 patients (28.7%) with coil (28 in Nid-occlud, 10 in Cook, 5 in Gianturco coil), in 27 (18%) patients with Amplatzer duct occluder (ADO) I, in 38 (25%) patients with ADO II, in 24 (16%) patients with ADO II Additional Size (ADO II AS) and in 18 (12%) patients Occlutech Duct Occluder (ODO) device. All 6 patients with failed PDA closure were attempt to be closed with coil. The mean duct diameter was 2.1 ± 1.24 mm, and the mean Qp/Qs ratio was 2 ± 0.95. Ductus diameter was greater in ADO I and ODO group than coil and ADO IIAS group, and in ADO I group than ADO II group. The Qp/Qs ratio was higher in ADO I group compared to the coil, ADO II and ADO IIAS groups, in ODO group than coil and ADO IIAS groups and in ADO II group than coil group. In a patient with residual shunt after PDA closure, a second coil was placed in the ductus after 1 year. The early closure rate was 85.3% after the procedure and the complete closure rate at the first day echocardiography was 99.3%. In the follow-up, mild left pulmonary artery stenosis in 2 patients and mild stenosis in the descending aorta in 3 patients were detected. Conclusion Transcatheter closure of PDA in children is a treatment option that can be preferred safely depending on the shape of the duct, device selection and clinician’s experience. With the increase of device diversity, the success rate of percutaneous closure is increasing. In our clinic, our successful closure rate increased with the introduction of duct occluder devices.