Abstract
ObjectiveThe objective is to share our experience of trans-catheter device closure of patent ductus arteriosus (PDA) and review its efficacy and immediate complications.MethodologyThis cross-sectional observational study was done in the Department of Pediatric cardiology, Lady Reading Hospital, Peshawar from January 2020 to December 2020. A total of 51 patients with isolated PDA, who underwent PDA device closure, were enlisted in this study through consecutive sampling methods, irrespective of their age and gender. Data of the patients were collected on preformed pro forma. Data was entered in SPSS 20 (SPSS Inc., Chicago, IL, USA). Descriptive statistics like mean ± SD for numerical data (age, weight, and hospital stay), while frequency and percentage for categorical variables (Device type, complication, hospital stay, and type of anesthesia given) were calculated.ResultsAmong total 51 patients (33 [64.7%] females and 18 [35.3%] males) with mean age 8.19 ± 6.96 years underwent attempted trans-catheter PDA device closure. In all cases PDA was successfully occluded with appropriate size devices. General anesthesia was given in 38 (74.5%) patients. Complications occurred in only four (7.8%) patients in the form of hemolysis followed by acute kidney injury in one patient, another had device embolization to descending aorta, which was retrieved in cath lab, one had device embolization to the right pulmonary artery, which was retrieved in cath lab and one had mild left ventricular systolic dysfunction. The mean duration of hospital stay was 22.0 ± 10.2 h.ConclusionTrans-catheter PDA device closure is a safe procedure with a high success rate and little morbidity.
Highlights
Patent ductus arteriosus (PDA) is a vascular communication between the left pulmonary artery with the descending aorta just after the origin of the left subclavian artery
In all cases PDA was successfully occluded with appropriate size devices
Complications occurred in only four (7.8%) patients in the form of hemolysis followed by acute kidney injury in one patient, another had device embolization to descending aorta, which was retrieved in cath lab, one had device embolization to the right pulmonary artery, which was retrieved in cath lab and one had mild left ventricular systolic dysfunction
Summary
Patent ductus arteriosus (PDA) is a vascular communication between the left pulmonary artery with the descending aorta just after the origin of the left subclavian artery. Persistent patency of the ductus arteriosus beyond a few weeks is considered abnormal [1]. PDA constitutes 6%-11% of all congenital defects and occurs in about one in 2,500-5,000 live births. Significant sized PDA causes symptoms of heart failure and poor weight gain in children [2,3]. PDA closure is recommended in every patient who presents with left ventricular volume overload even with no symptoms and no pulmonary artery hypertension (PAH) and device closure is the treatment of choice when technically possible [4]. The treatment of clinically silent or small PDAs is debatable [5]
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