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Updated: Oct 15, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter patent ductus arteriosus closure with echocardiographic guidance: can radiation exposure be reduced?
Ibrahim Cansaran Tanıdır1, Alper Güzeltaş2, Yakup Ergül2
1Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, İstanbul, Turkey. cansaran@yahoo.com.
Insights
Reducing radiation exposure in pediatric cardiac interventions is crucial. This study shows transcatheter closure of patent ductus arteriosus (PDA) in children can be done with less radiation and contrast using echocardiography instead of aortography.
Area of Science:
- Pediatric Cardiology
- Interventional Radiology
- Medical Imaging
Background:
- Children are more sensitive to radiation than adults, making radiation exposure during cardiac catheterization a significant concern.
- Transcatheter closure of patent ductus arteriosus (PDA) and other pediatric interventions raise concerns about radiation dose.
Purpose of the Study:
- To demonstrate a method for transcatheter closure of PDA in children using reduced ionizing radiation.
- To prove that radiation dose and contrast material can be decreased during pediatric PDA closure.
Main Methods:
- Device selection was based on PDA morphology and diameter.
- Procedures utilized Gianturco coils, Amplatzer Duct Occluders (ADO), Flipper coils, and Amplatzer vascular plugs.
- Echocardiography and control aortography findings were analyzed.
Main Results:
- Fluoroscopy time, radiation dose, and contrast volume were 12 ± 6.4 mins, 28.1 ± 14.7 cmGy/cm²/kg, and 4.2 ± 2.3 cc/kg, respectively.
- Control aortography revealed residual shunts in 39.7% of patients; real-time echocardiography showed shunts in 9.5%.
- Control aortography accounted for 13.3% of total radiation and 27.2% of total contrast.
Conclusions:
- Performing echocardiography instead of a final control aortography after transcatheter PDA closure can reduce patient radiation and contrast exposure.
- Echocardiographic evaluation is a viable alternative to aortography for assessing residual shunts post-procedure.
Objectives:
The radiation dose from interventional cardiac catheterization is particularly relevant when treating children because of their greater radiosensitivity compared to adults. The transcatheter closure of patent ductus arteriosus (PDA), as well as other more complex pediatric interventions, have raised concerns regarding radiation exposure, particularly relevant when treating children. The purpose of this study is to show how to perform the transcatheter closure of PDA in children while giving less ionized radiation and to prove that the amount of radiation and contrast material can be reduced.
Study Design:
Following appropriate device selection based on PDA morphology and diameter, transthorasic echocardiography images and control aortography findings were analyzed. The following devices were used during the procedure: Gianturco coils (10/63), an Amplatzer Duct Occluder (ADO, 31/63), Flipper coils (19/63), and an Amplatzer vascular plug (3/63).
Results:
The scopy time, radiation dose, and contrast were 12 ± 6.4 mins, 28.1 ± 14.7 cmGy/cm²/kg, and 4.2 ± 2.3 cc/kg, respectively. In the control aortography shortly after the procedure, residual shunt was detected at various levels in 39.7% of patients, and 9.5% demonstrated residual shunt in real-time echocardiography. In the control aortography, the exposure to radiation was 13.3% of the total, and the amount of infused contrast was 27.2% of the total.
Conclusion:
Patients may be exposed to less radiation and contrast material if an echocardiographic evaluation, instead of a final control aortography injection, is performed after the transcatheter closure of PDA.
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