Follow-Up Results of Device Occlusion of Patent Ductus Arteriosus

Abstract

BackgroundTranscatheter patent ductus arteriosus (PDA) closure is an established procedure.ObjectivesThe aim of the study was to assess midterm follow up of the Nit-Occlud coil and the amplatzer ductal occluder (ADO) closure of PDA.Patients and MethodsIn this cohort study, we collected the longitudinal data of patients who underwent percutaneous closure using coil or ADO from November 2005 to November 2013. A total of 404 patients with PDA closure by devices were included during the study period. Coil occlusion was performed in 220 patients and 184 patients underwent catheterization using ADO. Follow-up evaluations were performed with echocardiography at two weeks, two months, six months, and during the study period (in average 4.8 ± 3.8 years).ResultsThe patients’ mean age was 24 months (range: 1 - 312). The catheterization was successful in 393 (97.2%) patients and unsuccessful in 11 (2.7%). Immediate complete occlusion was seen in 290 (73.7 %) patients. The occlusion rates at two weeks, two months, six months, and during the study period were 73.7%, 84%, 93.6%, 98.7%, and 99.5%, respectively. Complications occurred in 23 (5.8%) patients during or immediately after the catheterization, and device embolization with 2.7% was the most common complication. Most complications occurred in a patient with pulmonary hypertension who was less than one year old and was undergoing the first year of experience with devices.ConclusionsOur findings showed that transcatheter occlusion of the PDA is an effective and safe intervention by coil or Amplatzer with excellent early and one-year outcomes. Pulmonary hypertension, age of less than 12 months and experience of less than one year may increase the complications of device closure.

Immediate and Short-term Changes in Left Ventricular Function in Children Undergoing Percutaneous Closure of Patent Ductus Arteriosus by Echocardiography and Tissue Doppler

“…The LVESD also showed a significant decrease immediately after PDA closure and continued to decrease at the onemonth follow up, but non significantly. These findings are concordant with the previous study conducted by Gupta et al (6) which showed a significant decrease of the LVESD at day-1 and at the short term follow up after PDA closure (11) . The decrease in LVESD in the short term follow up in our study was concordant with previous studies conducted by Amoogzar et al (11) , Galal et al (12) and Kim et al (5) .…”

“…As regards the LV dimensions, the LVEDD showed a significant decrease in the mean LVEDD and the mean LVEDD indexed to BSA immediately after successful PDA closure and continued to decrease in the one month follow up after closure but non significantly. These findings are concordant with the studies conducted by Amoogzar et al (11) ; Agha et al (7) ; Galal et al (12) ; Kim et al (5) and Gupta et al (6) . These studies reported that LVEDD decreases significantly after PDA closure and continues to decrease further at the onemonth follow up and after longer periods of follow up, up to six months, in some of these studies.…”

“…Moreover, the studies conducted by Gupta et al (6) and Amoogzar et al (11) also showed a significant decrease in LVEF immediately after closure which increased at the short-term follow up to be higher than the pre-closure value.…”

“…These results partially agreed with those of Agha et al (7) who reported a significant decline of all tissue Doppler velocities as well as E`/A` ratio immediately after PDA closure, which were reverted at 1 month (7) . On the other hand, Amoogzar et al (11) study showed no significant change in septal or lateral mitral annular peak systolic velocities (S) either early or late after PDA closure. It showed significant decrease in septal and lateral mitral annular early diastolic velocity (E`) early after 24 hours of PDA closure and an increase in the late follow up.…”

Patent Ductus Arteriosus Device Occlusion

“…Amoozgar et al reported 97.8% success rate with ADO device closure. 6 Sultan et al implanted PDA successfully in 98.2% patients. 12 In USA the reported success rate after ADO device closure is 99%.…”