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Published on: December 23, 2022
Transcatheter Closure of Patent Ductus Arteriosus in Adults
Ka-Chun Un1,2, Pramod Sagar3, Ronak Sheth4
1Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. ukc204@ha.org.hk.
Insights
Transcatheter closure of patent ductus arteriosus (PDA) is safe and effective in adults, with high success rates. However, adult PDA closure requires special considerations and further research is needed for optimal outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Adult Congenital Heart Disease
Background:
- Transcatheter closure of patent ductus arteriosus (PDA) is well-documented in pediatric patients.
- Limited data exist regarding transcatheter PDA closure in adult populations.
Purpose of the Study:
- To review current evidence on transcatheter PDA closure in adults.
- To supplement existing data with findings from a multi-center registry.
Main Methods:
- Systematic review of existing literature.
- Analysis of data from a multi-center adult patient registry.
Main Results:
- Transcatheter PDA closure in adults demonstrates high safety and efficacy (90-100% success).
- Low complication rates were observed in the multi-center registry.
- Adult PDA closure presents unique anatomical, imaging, and technical challenges.
- Pulmonary arterial hypertension is a common comorbidity influencing clinical decisions.
Conclusions:
- Transcatheter PDA closure is a viable option for adults but is technically more complex than in children.
- Further large-scale trials are essential to establish optimal strategies and long-term results for adult transcatheter PDA closure.
Purpose Of Review:
Data on transcatheter closure of patent ductus arteriosus (PDA) have been widely reported in pediatric but not adult patients. This paper serves as an overview of the currently available evidence and supplements it with additional data from our multi-centre registry.
Recent Findings:
Transcatheter closure of PDA is safe and effective in adults, with up to 90-100% success rate. Our multi-centre registry shows similar findings with low risk of complications. Yet there are special anatomical, imaging and technical considerations compared to the pediatric population, and the common presence of pulmonary arterial hypertension complicates clinical decision-making. Transcatheter closure is less commonly performed in the adult population and is not as straightforward as commonly perceived. Given the paucity of studies reported in the current literature, further large-scale trials are needed to determine the optimal approach and long-term outcomes.
