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Surgical ligation of a residually patent arterial duct following failed occlusion using transcatheter coils
Derek S Wheeler1, James Matthew Maxwell, W Bradley Poss
1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. dewheeler@mcg.edu
Insights
Transcatheter coil occlusion is common for patent arterial ducts, but surgical ligation remains vital. This case highlights successful surgical closure of a patent duct after failed coil attempts.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Transcatheter coil occlusion is a standard therapy for patent arterial duct (PDA) in pediatric cardiology.
- It shows comparable efficacy to surgical ligation in selected patients.
- Surgical ligation is still necessary for premature infants, low-weight infants, large PDAs, complex heart disease, or failed coil occlusion.
Observation:
- This report details a case of a moderately sized PDA.
- The PDA exhibited residual patency despite two prior transcatheter coil occlusion attempts.
- The patient subsequently underwent successful surgical ligation.
Findings:
- Successful surgical ligation was achieved for a PDA with residual patency after coil embolization failure.
- This underscores the continued importance of surgical intervention in specific PDA cases.
Implications:
- Surgical ligation remains a critical treatment option for patent arterial duct, especially when transcatheter methods fail.
- This case reinforces the role of surgical expertise in managing complex pediatric cardiac conditions.
Abstract:
Transcatheter techniques for occlusion of the persistently patent arterial duct using coils have become standard therapy at many centers for pediatric cardiology, and in selected patients have demonstrated comparable efficacy to surgical ligation. Surgical ligation may still be required in many cases, including premature infants or those born with low weight, those with ducts of large diameter, those with associated structural heart disease, and in circumstances of unsuccessful occlusion subsequent to attempted closure using coils. We report on the successful surgical ligation of an arterial duct of moderate size that exhibited residual patency despite two separate attempts at occlusion using coils.
