Safety and efficacy of transcatheter closure of large patent ductus arteriosus in adults with a self-expandable occluder |
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Authors: | Man-li Yu Xin-miao Huang Jia-feng Wang Yong-wen Qin Xian-xian Zhao Xing Zheng |
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Institution: | (1) Department of Congenital Heart Diseases, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany |
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Abstract: | Most occurrences of large patent ductus arteriosus (PDAs) of ≥10 mm have been surgically closed, and transcatheter closure
of these large PDAs was only reported in a few case reports. The present study reviewed our experience in transcatheter closure
of such large PDAs with a Chinese self-expandable occluder, which is similar to but much cheaper than the Amplatzer occluder.
From July 2000 to January 2008, 23 patients underwent transcatheter closure of large PDA ≥10 mm with this kind of occluder.
The mean (SD) age of the patients was 38.0 (15.6) years (range 18–75 years). Radiographs of the chest, electrocardiograms,
and echocardiograms were used for follow-up evaluation of the treatment within 1 day, 1 month, 6 months, and then every year
after successful closure. The mean (SD) angiographic PDA diameter was 12.8 (2.6) mm (range 10–18 mm) and the mean occluder
diameter was 18.0 (2.9) mm (range 16–22 mm). The occluders were delivered successfully and closed the PDA completely in 19
out of the 23 patients. Pulmonary arterial pressures decreased significantly after occlusion in patients with successful treatment:
67.3 (24.7) mmHg (range 29–122 mmHg) before occlusion and 42.3 (22.0) mmHg (range 19–98 mmHg) immediately after the procedure.
Radiographs of the chest and echocardiograms showed that the diameters of the left atrium, left ventricle, and the main pulmonary
artery decreased, and the ejection fraction (EF) increased at a mean (SD) follow-up of 36.3 (18.7) months (range 6–72 months).
No severe complication occurred. The immediate and long-term outcomes suggested that transcatheter closure of PDAs with the
native PDA occluder is a safe and effective treatment for adults with large PDA ≥10 mm. |
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