[Non-surgical closure of patent ductus arteriosus in children with the Rashkind double disk occluder]
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L Ballerini1, C E Mullins, A Cifarelli
1Dipartimento Medico Chirurgico di Cardiologia Pediatrica, Ospedale Bambino Gesù, Roma.
Insights
Transcatheter closure of patent ductus arteriosus (PDA) in children is now routinely performed in select centers. This study reports the first successful series in Italy and Southern Europe, demonstrating a safe and effective non-surgical alternative.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Transcatheter closure of patent ductus arteriosus (PDA) is a specialized procedure.
- Routine performance is limited to major Pediatric Cardiology Centers.
- This study introduces the first series in Italy and Southern Europe.
Purpose of the Study:
- To report the initial experience with transcatheter PDA closure in children in Italy and Southern Europe.
- To evaluate the efficacy and safety of the Rashkind PDA occluder for non-surgical PDA closure.
- To establish this technique as a viable alternative to surgery in the region.
Main Methods:
- The study included 11 children (aged 1.6-10 years) with PDA.
- The Mullins method was used for device delivery during cardiac catheterization.
- The Rashkind PDA double-disk occluder was employed for closure.
Main Results:
- Successful closure was achieved in 10 out of 11 patients.
- Near-complete closure was observed in the remaining patient.
- Normal Doppler flow patterns confirmed procedural success.
- No complications were reported during the study.
Conclusions:
- Non-surgical transcatheter closure of PDA is an effective treatment option for children.
- This technique offers an excellent alternative to surgical intervention.
- The findings support the expansion of this procedure in Italy and Southern Europe.
Abstract:
Since the first clinical application of transcatheter closure technique for patent ductus arteriosus in children and infants in 1977 by Rashkind and Coll., this technique is routinely performed only in a few major Pediatric Cardiology Centers. We report our successful series which is the first of its kind both in Italy and in Southern Europe. The series included 11 children aged 1.6 to 10 years (mean age 4.5 years) all affected with patent ductus arteriosus (PDA). Subaortic stenosis (1) and ventricular septal defect with pulmonary stenosis (1) were associated anomalies. In all of the cases, after the standard percutaneous cardiac catheterization, the Mullins method was attempted to advance and deliver the Rashkind PDA double-disk occluder. Successful closure was accomplished in 10 while almost complete closure was achieved in the 11th. Normal Doppler flow pattern after the procedure confirmed the successful results. No complications occurred. Although our experience is limited, non-surgical PDA closure provided an excellent alternative to surgical procedure.