Abstract
Introduction: Trans-catheter closure (TCC) of patent ductus arteriosus (PDAs) is a well-establishednon-surgical method of closure. Objectives: To evaluate safety, feasibility & complicationsof device closure of patent ductus arteriosus (PDA) in small children weighing ≤ 5 kg with different types of devices for closure. Methods: patients with PDA underwent transcatheter closure, among whom 16 (33%) weighed 5 kg or less. All of these patients underwent transcatheter closure of PDA using an Amplatzer duct occluder I, Amplatzer duct occluder II or Amplatzer duct occluder 2 IIAS (Additional size) devices. Results: Sixteen patients (9 females & 7 males) between theages 20 days to 16 months had undergone device closures. Amplatzer Duct Occluder (ADOI) was used in 12 cases, 3 were closed with Amplatzer Duct Occluder (ADO2) and one the smallest of all (1.6 kg) patientwere selected for closure with Amplatzer Duct Occluder (ADO2 AS).At 1 month after the closure, the signs and symptoms improved markedly in all patients, and PDAs were completely closed and devices remained in situ on follow-up. Mild obstruction of left pulmonary artery (n=2) and aortic isthmus flow (n=1) was noted at the time of discharge which gradually improved on follow up. Conclusions: TCC of PDAin small babies 5 kg or less is feasible & safe alternative to surgical PDA closure in carefully selected patients. The immediate & short-term outcomes have proven this method to be safe & valid.
Highlights
Trans-catheter closure (TCC) of patent ductus arteriosus (PDAs) is a well-established non-surgical method of closure
From March 2018 to January 2019, 16 patients (9 females, 7 males) between 20 days to 16 months of life underwent trans-catheter closure of PDA as an alternative to standard surgical ligation with use of different devices
As far as devices are concerned we used Amplatzer Duct Occluder (ADOI) in 11 cases, Amplatzer duct Occluder (ADOII) in 4 cases and only one PDA was closed with Amplatzer Duct Occluder (ADOIIAS)
Summary
Trans-catheter closure (TCC) of patent ductus arteriosus (PDAs) is a well-established non-surgical method of closure. Objectives: To evaluate safety, feasibility & complications of device closure of patent ductus arteriosus (PDA) in small children weighing ≤ 5 kg with different types of devices for closure. At 1 month after the closure, the signs and symptoms improved markedly in all patients, and PDAs were completely closed and devices remained in situ on follow-up. PDA is defined as persistent patency in term infants even after three months [2]. It may be asymptomatic and is sometimes not diagnosed early resulting into prolonged abnormal aorto-pulmonary shunt which may result in silently progressing hypertension and left ventricular dysfunction. Since the first percutaneous closure of PDA performed by Porstmann in 1968, various devices and coils have been introduced into
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