[Percutaneous transfemoral plug closure of patent ductus arteriosus in 100 cases]

One hundred patients with patent ductus arterious (PDA) were treated successfully by percutaneous transfemoral plug closure since 1985. Age ranged from 5 to 48 years. Among them five had previous ligation of PDA, One was complicated with infective endocarditis, and in four pulmonary hypertension were found. The internal diameter shown in aortograph ranged from 0.26-1.0 cm. Primary success was accomplished after the first trial in 97 patients and second trial was necessary in three cases. However in one patient plug closure was given up after unsuccessful trial. The plug closure was carried out with domestic-made material and instrument in all cases. We adopted the modified Porstmann technique. We believe that the infrainguinal transfemoral approach is simple, and less traumatic. The indication of plug closure can be extended especially to residual or recanalization cases after ligation in selected cases. It may become the method of first choice for PDA. The "papillary type" of PDA is discussed and a specially designed and tailored plug and also a spontaneous flow-directed method were recommended. Frequent ventricular premature beats usually occurred while the catheters were being pushed through chordae tendinae of the tricuspid valve and the way of prevention was discussed. In case of dislodgement of plug, reestablishing the wire locus would be necessary. One to sixty-eight months follow up study after closure showed no sign of recanalization or residual shunt.