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Transcutaneous Closure of Persistent Ductus Arteriosus: Complication Rates and Long-term Follow-up, a Single-Centre

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Transcutaneous closure of patent ductus arteriosus (PDA) in children has a 5.1% major complication rate, often appearing within 24 hours. Longer-term surveillance is advised for patients receiving ADO1 devices due to potential late obstruction.

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Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Transcutaneous closure of patent ductus arteriosus (PDA) is a common pediatric procedure.
  • Variability exists in long-term follow-up by pediatric cardiologists.
  • Characterizing complications and discharge timing can optimize patient care.

Purpose of the Study:

  • To determine complication rates following transcutaneous PDA closure in children.
  • To assess the timing of discharge after PDA closure procedures.
  • To identify factors associated with postoperative complications.

Main Methods:

  • Retrospective study of pediatric patients (0-15 years) undergoing transcutaneous PDA closure.
  • Data collected from January 2006 to December 2015 at a single center.
  • Analysis of complication types, severity, and timing relative to the procedure.

Main Results:

  • 12% of 156 patients experienced complications; 5.1% had high-grade issues (e.g., device embolization, need for surgery).
  • Moderate to low-grade complications (e.g., flow acceleration) occurred in 6.4%; 77% were immediately apparent.
  • 2% developed late mild-to-moderate aortic or LPA obstruction, particularly with larger ADO1 devices; younger age and larger device size were risk factors.

Conclusions:

  • PDA occlusion has a 5.1% major complication rate, typically seen within 24 hours.
  • A small percentage (2%) treated with ADO1 devices developed late obstruction, warranting continued surveillance.
  • Longer-term follow-up may be prudent for patients receiving ADO1 devices, especially those with larger ducts.