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Percutaneous transcatheter PDA device closure in infancy
Maad Ullah1, Mehboob Sultan1, Khurram Akhtar1
1Department of Paediatrics Cardiology, Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi.
Insights
Transcatheter device closure is effective for patent ductus arteriosus (PDA) in infants, but local vascular complications are common. This study evaluated outcomes and issues in infant PDA closure.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Neonatal Medicine
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect in infants.
- Transcatheter closure offers a minimally invasive alternative to surgical intervention for PDA.
Purpose of the Study:
- To assess the efficacy and safety of transcatheter device closure for PDA in infants.
- To identify and analyze complications associated with the procedure.
Main Methods:
- A quasi-experimental study involving infants undergoing transcatheter PDA closure.
- Pre-procedural evaluation using 2-D echocardiography and Doppler by pediatric cardiologists.
- Recording of procedural success rates and any occurring complications.
Main Results:
- Successful transcatheter closure was achieved in 96.1% of eligible infants (50 out of 52).
- Complications included acquired coarctation in one infant and non-fatal cardiac arrest during device deployment in another.
- Local vascular access site complications occurred in 21.8% of cases but were managed successfully.
Conclusions:
- Transcatheter device closure is a largely effective treatment for PDA in infants.
- A significant incidence of local vascular complications necessitates careful monitoring and management.
Objective:
To evaluate the results and complications associated with transcatheter closure of patent ductus arteriosus (PDA) in infants.
Study Design:
Quasi-experimental study.
Place And Duration Of Study:
Paediatric Cardiology Department of Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from December 2010 to June 2012.
Methodology:
Infants undergoing transcatheter device closure of PDA were included. All patients were evaluated by experienced Paediatric Cardiologists with 2-D echocardiography and Doppler before the procedure. Success of closure and complications were recorded.
Results:
The age of patients varied from 05 - 12 months and 31 (56.4%) were females. Out of the 55 infants, 3 (5.4%) were not offered device closure after aortogram (two large tubular type ducts and one tiny duct, considered unsuitable for device closure); while in 50 (96.1%) patients out of remaining 52, the duct was successfully closed with transcatheter PDA device or coil. In one infant, device deployment resulted in acquired coarctation, necessitating device retrieval by Snare followed by surgical duct interruption and another patient had non-fatal cardiac arrest during device deployment leading to abandonment of procedure and subsequent successful surgical interruption. Local vascular complications occurred in 12 (21.8%) of cases and all were satisfactorily treated.
Conclusion:
Transcatheter device closure of PDA in infants was an effective procedure in the majority of cases; however, here were considerable number of local access site vascular complications.
