Trans-Catheter Closure of Patent Ductus Arteriosus, which device should we use?

Despite the operational experience in the percutaneous closure of Patent ductus arteriosus (PDA), complications can arise during the procedure. To overcome these complications the choice of the device must be adapted to each patient.

To report the experience of the cardiology department in the transcatheter device closure of PDA and to determine the influencing factors of choice of the device.

Our study included patients with patent ductus arteriosus that are admitted for transcatheter closure, between September 2003 and June 2016.

One hundred and fifty-three patients were included in our study. Transcatheter closure was not done in 9 cases. The transcatheter closure was successful in 140 patients. The complications were observed in 11 patients that includes device embolization in 3 cases, aortic protrusion in four cases pulmonary protrusion in three cases and inguinal hematoma in one another. Three predictive factors of complications were: age < 2 years, tubular PDA type C and ratio duct diameter/weight > 0.95. A mild residual shunt was observed at the end of the procedure in 22.85 % of the patients. The risk of residual shunt was significantly increased when the age < 2 years, the large PDA, the presence of pulmonary hypertension and the tubular C PDA.

The choice of the device depends essentially on age, the weight and the duct anatomy.