[Percutaneous balloon exploration and plug closure of arterial duct]

Percutaneous plug closure of arterial duct (AD) was performed on 38 patients, with ages ranging from 6 to 54 years. The inside diameter of AD varied from 3.7 to 11.6 mm and the shunt size of AD was 8-77% of the pulmonary flow. A combined technique was used in the closure operation, which employs a balloon catheter to explore the size of AD as well as its distensibility and a catheter scale to examine the compatibility of the foam plug with the AD to be closed. Total occlusion was achieved in all the 38 cases, the success rate being 100%. Immediately after the procedure, blood oxygen analysis showed an interruption of the left-to-right shunt and the pulmonary artery pressure decreased from 4.71 +/- 0.80 to 3.34 +/- 0.53 kPa (P less than 0.001). Four to 7 days later, the cardiothoracic ratio reduced from 52.8 +/- 4.6 to 49.7 +/- 4.2% (P less than 0.001) and the cardiac index decreased from 6.00 +/- 1.31 to 4.46 +/- 0.80 L/min.m-2 (P less than 0.001). Random color Doppler flow imaging suggested no residual shunts. No major complications were observed in any of the cases and follow-up observations in 1 to 24 months showed no plug displacement or recanalization.

the balloon exploration is able to make certain of the "occlusion diameter" of AD and the scale examination can surely sort out the plug most compatible with the AD to be closed, so that success of every step for the closure is ensured.