Catheter Closure of Patent Ductus Arteiosus Using the Amplatzer Duct Occluder and Unexpected Complication

Lee, J E; Jang, S I; Sim, E J; Cho, D J; Kim, D H; Min, K S; Yoo, K Y

Abstract

PROPOSE: The aim of this study was to report results and unexpected complications with transcatheter closure of the patent ductus arteriosus(PDA) using the PDA Amplatzer duct occluder(ADO) that is an efficient and safe device. METHOD: From December 1998 to June 2004, twenty-six patients(8 male, 18 female) underwent attempted transcatheter closure of a PDA using the ADO at a median age of 8.0+/-8.44 years(range 0.7 to 37) and median weight of 23.1+/-17.30 kg(range 7.5 to 62). The mean PDA diameter was 4.7+/-1.26 mm(range 2.9 to 8.6 mm). A 5F to 7F long sheath was used for delivery of the ADO. Follow-up evaluation was performed with two-dimensionalcolor Doppler echocardiographic study and chest radiographic study immediate 24 h and 1 and 3 months after closure.
RESULTS
All patients had successful placements. Angiography showed that 23 patients had complete immediate closure, 2 patients had a small leak, and 1 patient had a trivial leak. Within 24 hours, color Doppler revealed complete closure in two patients who had a small leak. After 1 year follow-up, one remaining patient showed a complete closure. The median fluoroscopic time was 20.8+/-5.2 min(range 8 to 40 min). We have seen no late complications such as hemolysis, recanalization, device migration, or device relating obstruction of the pulmonary arteries or descending aorta. We had experienced four unexpected complications.
CONCLUSION
Our results proved that transcatheter closure using the ADO is an effective and safe therapy for patent ductus arteriosus. But we have to consider that unexpected complication can happen during procedure. Further studies are required to establish long-term results in a larger patient population.