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[Transcatheter occlusion of the persisting arterial duct]
Ch Kampmann1, W Kuroczynski, Ch M Wiethoff
1Kinderkardiologie der Universitätskinderklinik. christoph.kampmann@uni-mainz.de
Background:
Transcatheter occlusion of the persisting arterial duct (PDA) is feasible using different techniques like coil-embolization (CE), Rashkind PDA occluder (Rash), Amplatzer Duct Occluder (ADO). Comparative studies with this devices in relation to the size of the PDA and the device are missing. Aim of this study was to evaluate the different systems at the own patient population.
Patients And Methods:
From 1993 to 12/2001 transcatheter occlusion was attempted in 92 patients aged 4,13 years (range 0,07 to 14,39 years) using CE, Rash or ADO. All patients received echocardiographic examinations 24 hours before and after intervention, after 3, 6, and 12 months and than yearly.
Results:
91/92 PDAs could be successfully closed by 97 interventions. There were 63 CE, 25 Rash and 9 ADO performed. Primary closure rate was 75 % for Rash, 80 % for ADO and 80,8 % for CE (n. s.) and after 6 months 88 % for Rash, 92,3 % for CE and 100 % for ADO (p < 0,001), although the size of the PDA increased significantly from CE (2,14 + 1,1 min) to Rash (3,2 +/- 1,3 min) to ADO (4,9 +/- 1,9 min) (p < 0.05). In 6/7 pts with residual shunts complete occlusion could be achieved by second intervention.
Conclusion:
In dependency of the size of the PDA and the right choice of the occluder almost all PDAs are closable with transcatheter techniques.