Iatrogenic cardiovocal syndrome caused by transcatheter coil closure of patent ductus arteriosus

Two infants developed hoarseness unexpectedly the day after transcatheter coil closure of a slender patent ductus arteriosus (PDA). The pathogenesis of this complication appears to be similar to that of the classic cardiovocal syndrome. During the intervention, the inappropriately implanted coil might have distorted the slender PDA, thereby causing angulation of the pliable PDA itself and precipitating impingement on the left recurrent laryngeal nerve. Fortunately, both infants recovered spontaneously from the hoarseness within several weeks. At present, the definite underlying neuropathology of this complication is unknown as we have not yet confirmed recovery of the left vocal cord movement by follow-up fibreoptic bronchoscopy. Conclusion: Iatrogenic cardiovocal syndrome could occur in infants after transcatheter coil closure of a slender PDA, using the currently popular 0.038-inch coil. A coil with a smaller diameter might prevent the occurrence of this syndrome.