Transcatheter closure of patent ductus arteriosus with coils

Objectives. This study was performed to assess the efficacy and short to medium-term results in children of transcatheter closure of the patent ductus arteriosus with coils. Background. Transcatheter closure of the patent ductus arteriosus using coils has been reported in the English literature with encouraging result. Experience here and the short to medium-term results in Chinese children of transcatheter closure of the patent ductus arteriosus is reported. Materials and Methods. Thirty-nine patients underwent transcatheter closure of patent ductus arteriosus with coils. Median age was 4.3 years and median body weight was 17.0 Kg. The ductal diameters ranged from 0.5 mm to 4.5 mm with mean of 1.84 mm. The calculated pulmonary to systemic flow (Qp/Qs) ratio by Fick's principle was 1.01 to 3.31, with mean±SD=1.41±0.45. Results. One to three coils were inserted in every patient, depending on the ductal diameter. A larger ductal diameter implies a need for more coils. All patients with a ductal diameter exceeding 2.6 mm required two or more coils. Thirteen coils had embolized to the left or right pulmonary arteries in seven patients. All of the pulmonary embolized coils were retrieved with a snare catheter. Two patients were given up and eventually sent for surgical ligation because of repeated coil embolization in the pulmonary arteries. The other 11 cases had successful coils subsequently placed to close the ductus arteriosus. The ductal murmur disappeared immediately after catheterization in all 39 children. A follow-up study with Doppler technique and color Doppler flow mapping revealed that complete closure was achieved in 71.8%, 74.4%, 79.5%, 92.3%, 92.3%, 91.4% and 94.7% at 24 hours, 48 hours, 7 days, 1 month, 3 months, 6 months and 1 year, respectively. There were no other complications. Conclusion. Transcatheter closure of the patent ductus arteriosus with coils is an extremely safe and effective method for use in children. Both short and medium-term results are excellent.