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Transcatheter closure in 354 pediatric cases of patent ductus arteriosus using five different devices
1Department of Pediatrics, Guangdong Cardiovascular Disease Institute, Guangzhou 510100, China.
Insights
Transcatheter closure of patent ductus arteriosus (PDA) using Sideris, Coil, and Amplatzer devices demonstrated superior safety and effectiveness compared to other methods. These devices offer better outcomes for pediatric PDA occlusion.
Area of Science:
- Cardiology
- Pediatric cardiology
- Medical devices
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect.
- Transcatheter closure is a primary treatment for PDA.
- Comparing different closure devices is crucial for optimizing patient outcomes.
Purpose of the Study:
- To evaluate and compare the efficacy and safety of five distinct transcatheter devices for PDA closure.
- To identify the most effective and safest device for pediatric PDA treatment.
Main Methods:
- A study involving 354 patients with PDA, comparing five closure devices: Porstmann Ivalon plug, Rashkind double umbrella, Sideris button device, Coils, and Amplatzer occluders.
- Assessment of PDA diameter and pulmonary-to-systemic flow ratio (Qp/Qs).
- Follow-up at 24 hours and 6 months using color flow mapping.
Main Results:
- Sideris, Coil, and Amplatzer devices achieved 100% successful occlusion rates.
- The Sideris device had no reported complications.
- Lower complication rates were observed with Rashkind, Coil, and Amplatzer devices compared to the Porstmann device.
Conclusions:
- Sideris device, Coils, and Amplatzer occluders are highly effective and safe for transcatheter PDA closure in children.
- These devices represent an improvement over the Porstmann and Rashkind devices for pediatric PDA treatment.
Objective:
To assess the effect of transcatheter closure of patent ductus arteriosus (PDA) by comparing five different devices.
Methods:
354 patients (135 males, 219 females) underwent transcatheter closure of PDA using the Porstmann Ivalon plug, Rashkind double umbrella, Sideris button device, Coils and Amplatzer occluders. The mean PDA diameter at its narrowest segment was 3.1 +/- 1.3 mm. Qp/Qs was 2.2 +/- 0.5. Follow-up evaluation was performed with color flow mapping of the main pulmonary artery at 24 h and 6 months after closure.
Results:
Successful occlusion was observed in 92% (23/25) for the Porstmann device, 98.7% (77/78) for the Rashkind device, 100% (43/43) for the Sideris device, 100% (69/69) for the Coil and 100% (139/139) for the Amplatzer device. No residual shunts were needed for the Porstmann, while 1.4%-15% of patients who received the Rashkind, Sideris, Coils or Amplatzer needed residual shunts during follow-up. There were complications of 24% (6/25) for the Porstmann, 3.8% (3/78) for the Rashkind, 1.4% (1/69) for Coils and 1.4% (2/139) for the Amplatzer. No complications were found in patients with the Sideris device.
Conclusion:
The results showed that the Sideris device, Coils and the Amplatzer device are more effective and safer than the others for the occlusion of PDA in children.