Related Experiment Video
Updated: May 22, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Transcatheter closure of symptomatic arterial duct in infants younger than 1 year old
Biagio Castaldi1, Giuseppe Santoro, Gianpiero Gaio
1Department of Paediatric Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy.
Insights
Transcatheter closure of the patent arterial duct is safe and effective in infants under 12 months. Device choice tailored to anatomy ensures successful outcomes with low complication rates.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Transcatheter closure is the preferred treatment for patent arterial duct (AD).
- This approach presents challenges in infants under 12 months old.
- Symptomatic infants often exhibit cardiac overload and require anticongestive therapy.
Purpose of the Study:
- To assess the feasibility, safety, and mid-term efficacy of percutaneous AD closure in infants <12 months.
- To compare outcomes between detachable coils and Amplatzer Duct Occluder (ADO) devices.
Main Methods:
- Retrospective analysis of 69 infants <12 months undergoing transcatheter AD closure.
- Devices used: detachable coils (n=24) or ADO (n=45).
- Evaluation of procedural success, complication rates, and occlusion rates at discharge and mid-term follow-up.
Main Results:
- Procedural feasibility was high (95.7%) with no significant difference between device groups.
- Overall complication rate was low (1.5%).
- Occlusion rates were 86% at discharge and 98.5% at mid-term follow-up (mean 55 months).
Conclusions:
- Percutaneous closure of symptomatic patent arterial duct is effective and safe in very young infants.
- Tailoring device selection to ductal morphology and local anatomy is crucial for success.
- Controlled-release coils demonstrate comparable mid-term efficacy to ADO devices.
Abstract:
Transcatheter closure is currently considered the first-choice therapeutic option in patent arterial duct (AD), although this approach remains challenging in younger patients. To evaluate feasibility, safety, and mid-term efficacy of percutaneous AD closure using different devices in symptomatic infants <12 months old. Among the 483 patients who underwent transcatheter AD closure at our institution from April 2000 to January 2012, 69 were <12 months old. All patients showed cardiac overload at echocardiography, and 72 % of them were on anticongestive therapy. Based on ductal morphology and local anatomy, AD closure was attempted using detachable coils in 24 cases (group A) or the Amplatzer Duct Occluder (AGA Medical, Golden Valley, MN) device in 45 cases (group B). Procedural feasibility was 95.7 % without any difference between groups (95.8 % vs. 95.6 %, p = NS) as were fluoroscopy and procedural times. AD size was 2.5 ± 0.9 mm, and QP/QS ratio was 2.2 ± 1.1, with both being significantly higher in group B [2.1 ± 0.9 vs. 2.6 ± 0.9 mm (p = 0.04) and 1.7 ± 0.8 vs. 2.5 ± 1.2 (p = 0.009), respectively]. Overall complication rate was 1.5 %, without any difference between groups, as was the occlusion rate at hospital discharge (86 %) and over midterm follow-up (55 ± 36 months) (98.5 %). Percutaneous closure of symptomatic AD might be considered effective and safe in very young infants by tailoring the device choice to ductal morphology and local anatomy. In this setting, the controlled-release coil option was shown to be as effective as the ADO device during midterm follow-up.
