Korean J Pediatr.  2018 Dec;61(12):397-402. 10.3345/kjp.2018.06548.

Outcomes of transcatheter closure of ductus arteriosus in infants less than 6 months of age: a single-center experience

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. amyjys@naver.com

Abstract

PURPOSE
Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old.
METHODS
We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed.
RESULTS
A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was 3.3±1.5 months, and weight was 5.7±1.3 kg. The duct diameter at the narrowest point was 3.0±0.8 mm as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P < 0.01).
CONCLUSION
A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.

Keyword

Congenital heart disease; Patent ductus arteriosus; Transcatheter closure

MeSH Terms

Angiography
Aortic Coarctation
Classification
Ductus Arteriosus*
Ductus Arteriosus, Patent
Heart Defects, Congenital
Humans
Incidence
Infant*
Intubation
Retrospective Studies
Vascular System Injuries
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