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Transcatheter closure of a large patent ductus arteriosus using jugular access in an infant

Precylia Fernandes1, Anass Assaidi2, Alban-Elouen Baruteau3

  • 1Department of Paediatric Cardiology, Royal Brompton Hospital, London, UK.

Journal of Thoracic Disease
|May 1, 2018
PubMed

Insights

Trans-catheter closure of patent ductus arteriosus (PDA) is effective. A trans-jugular approach proved safe and successful for PDA device closure in an infant when femoral access was challenging.

Area of Science:

  • Interventional Cardiology
  • Pediatric Cardiology
  • Medical Device Technology

Background:

  • Trans-catheter device closure is a standard, safe, and effective treatment for patent ductus arteriosus (PDA).
  • The femoral venous route is typically used for trans-catheter PDA closure.
  • Trans-jugular access has been previously utilized in specific pediatric cases, such as interrupted inferior vena cava.

Observation:

  • A 6-month-old infant weighing 8 kg presented for percutaneous closure of a 4.5 mm PDA with left heart dilatation.
  • Standard femoral venous access was unsuccessful in this infant.
  • A trans-jugular venous approach was chosen as an alternative access route.

Findings:

  • Successful occlusion of the PDA was achieved using an 8/6 mm Amplatzer duct occluder (ADO) via the trans-jugular route.
  • Aortography confirmed successful closure of the PDA.
  • Post-procedure echocardiography revealed no residual shunt, indicating a successful outcome.

Implications:

  • This case demonstrates the safety and efficacy of the trans-catheter trans-jugular approach for PDA device closure, even in infants.
  • The trans-jugular route provides a viable alternative when femoral venous access is not feasible in pediatric patients.
  • This technique expands interventional options for treating congenital heart defects in infants.

Keywords:
Patent ductus arteriosus (PDA)device closuretransjugular route

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