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[Percutaneous closure of patent ductus arteriosus with the Rashkind device]
F M Martins1, I C de Menezes, M C Telo
1Unidade de Cardiologia Pediátrica, Hospital de Santa Cruz, Portugal.
Insights
Percutaneous closure of persistent ductus arteriosus using the Rashkind device is effective and safe. This minimally invasive technique achieved total closure in 26 of 30 patients, offering a viable alternative to surgery.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Persistent ductus arteriosus (PDA) is a common congenital heart defect.
- Surgical closure has historically been the standard treatment for PDA.
- Minimally invasive percutaneous techniques are increasingly explored for PDA management.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous closure of PDA using the Rashkind device.
- To assess the long-term outcomes of Rashkind device implantation for PDA.
Main Methods:
- A prospective study involving 30 patients with PDA.
- Rashkind double umbrella occluder devices were implanted percutaneously via cardiac catheterization.
- Patients underwent clinical, angiographic, and echocardiographic assessments post-procedure with follow-up up to one year.
Main Results:
- Successful device implantation was achieved in all 30 patients.
- Total ductal closure was observed in 26 patients (86.7%).
- Occlusion was achieved with a single device in 21 patients and two devices in five patients, with no reported complications.
Conclusions:
- Percutaneous closure of PDA with the Rashkind device is an efficient and safe alternative to surgical intervention.
- The Rashkind device demonstrates a high success rate for PDA closure in a diverse patient population.
- This interventional cardiology approach offers a favorable risk-benefit profile for managing PDA.
Purpose:
To assess the efficacy and safety of the percutaneous closure of the persistent ductus arteriosus with the Rashkind device.
Design:
Clinical, angiographic and echocardiographic assessment of the patency of the ductus arteriosus at the time of the implantation of the first or second Rashkind device, followed by clinical and echocardiographic control at one, three and six months and yearly thereafter.
Patients:
Thirty two patients with patent ductus arteriosus. Twenty seven were female and five male. Their ages ranged between 10 months and 33 years (6.8 +/- 7.7 years) and their weights between 7.3 and 52 (20.1 +/- 12.4) kg. Two patients were excluded due to a ductal diameter greater than 8 mm. Thirty patients had successful device implantation.
Methods:
Implantation at cardiac catheterization of the Rashkind double umbrella occluder device in the narrowest portion of the patent ductus arteriosus. Twenty one patients had one device implanted and five had the implantation of a second device four to 12 months later, due to persistent patency of the ductus.
Results:
Total closure was achieved in 26 out of 30 patients. In 21 patients the occlusion was obtained with a single device and in five patients with two devices. Among the remaining four patients, one is awaiting the implantation of a second device and the other three are under follow-up as their first devices were implanted recently. There were no complications.
Conclusions:
Percutaneous closure of the ductus arteriosus with the Rashkind device represents an efficient and safe alternative to surgery in most patients.