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Published on: February 8, 2022
Transcatheter coil occlusion of patent ductus arteriosus
P Lertsapcharoen1, P Chottivitayatarakorn, V Benjacholamas
1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
Percutaneous coil occlusion effectively treated small patent ductus arteriosus (PDA) in children. This minimally invasive procedure offers a safe alternative to surgery with successful outcomes in most cases.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect.
- Surgical closure has historically been the standard treatment for PDA.
- Percutaneous interventions offer less invasive alternatives.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous coil occlusion for small PDA in pediatric patients.
- To assess the success rate and potential complications of the coil occlusion procedure.
Main Methods:
- Retrospective review of 17 pediatric patients with small PDA undergoing percutaneous coil occlusion.
- Data collected included patient demographics, PDA size, coil implantation details, and procedural outcomes.
- Follow-up included clinical assessment and imaging (aortography or color flow echo).
Main Results:
- Successful coil implantation in 15 out of 17 patients (88.2%).
- Complete PDA closure achieved in 14 patients (82.4%).
- Two cases (11.8%) experienced coil migration to pulmonary arteries without complications; both underwent successful surgical closure.
Conclusions:
- Percutaneous coil occlusion is a safe and effective treatment for small PDA in children.
- The procedure demonstrates a high success rate and a low complication profile.
- Coil occlusion serves as a viable alternative to surgical intervention for PDA.
Abstract:
Between May 1995 and October 1997, 17 cases of small patent ductus arteriosus (PDA) underwent percutaneous coil occlusion at the Department of Pediatrics, Chulalongkorn Hospital. The mean age was 5.3 +/- 3.6 years (range, 1 year 4 months to 12.0 years); mean weight was 18.9 +/- 11.7 kg (range, 9 to 48 kg). The mean minimum diameter of the PDA was 2.8 +/- 0.6 mm (range, 1.7 to 4.0 mm). PDA occlusion was achieved with one coil in 9 patients and two coils in 8 patients. One patient required the second coil occlusion procedure to occlude the residual PDA leakage. Of the 17 patients, coils were successfully implanted in 15 patients: complete closure of PDA was obtained in 14 patients, confirmed by aortography or by color flow echo imaging or both. In the two unsuccessful coil implantation cases, coils migrated to the distal left pulmonary artery (1 case) and the distal right pulmonary artery (1 case). They could not be retrieved. Both patients had surgical closure of PDA on the following day after the failed procedure. No clinical and chest X-ray showed any evidence of pulmonary complication from the migrated coils up to 1-year follow-up. PDA coil occlusion provides an alternative to surgical closure. The procedure is safe and has a good result.
