Procedural outcome and safety of percutaneous patent ductus arteriosus occlusion in adults
Abdul Malik Sheikh1, Asma Kanwal1, Hina Sattar2
1Department of Pediatric Cardiology Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan.
Background:
Percutaneous device closure of patent ductus arteriosus (PDA) in infants and children is a frequently performed procedure. However, transcatheter closure is rare in adults, especially in developed countries, as most ducts are typically closed in childhood. PDA in adults poses unique challenges due to age-related comorbidities and some morphological changes in PDA that occur with advanced age. This study analyzes the safety and procedural success of adult PDA transcatheter closure.
Materials And Methods:
A retrospective single-center study analyzed 184 adult PDA device closures between July 2015 and July 2024. The study examined patient demographics, clinical aspects, procedural details, and immediate hospital outcomes. Outcome parameters focused on procedural success, complications, residual shunt, and improvement in symptoms.
Results:
Out of 184 patients, 183 adults with a mean age of 27 ± 13 years and a mean weight of 52 ± 16.5 kg underwent PDA device occlusion. Most patients were referred for evaluation of a murmur (n = 116, 63.3%). The most common comorbidity was type 2 diabetes mellitus (n = 20, 10.9%). The mean PDA diameter at its narrowest end was 6.17 ± 4.56 mm (1.2-17 mm). In total, 6.55% of patients exhibited duct calcification, and 2.73% presented with a PDA aneurysm. Severe pulmonary hypertension was present in 24 patients. Transcatheter intervention achieved a 100% success rate at 24 h postprocedure, with no residual flows at the 6-month follow-up. There was no mortality, device embolization, or aortic/pulmonary artery stenosis.
Conclusions:
Percutaneous device closure is a safe and successful treatment option for PDA in adults.
