Outpatient closure of the patent ductus arteriosus

We have modified and applied to selected outpatients the transvenous approach to correction of patent ductus arteriosus (PDA) with the Rashkind PDA Occluder. Modifications included establishing the diagnosis and PDA anatomy before catheterization with echocardiography. The sedation/anesthetic regimen was altered to meet the needs with respect to transcatheter PDA closure rather than diagnostic cardiac catheterization. Anticoagulation was avoided. A strategy for management of pin entrapment in the foam was devised. Residual trans-PDA flow after umbrella placement was temporarily occluded with balloon-tipped catheters. These modifications were used in 23 consecutive patients with uncomplicated PDA. Closure was successful in each child. Nineteen of 23 patients were discharged on the day of the procedure. No serious complications were encountered.