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Updated: Aug 10, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter closure of patent ductus arteriosus using controlled-release coils
A Celiker1, A Bilgiç, D Alehan
1Department of Pediatric Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Controlled-release coils offer a safe and effective transcatheter closure for patent ductus arteriosus (PDA). This minimally invasive procedure is valuable, especially in resource-limited settings.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Patent ductus arteriosus (PDA) is a common congenital heart defect.
- Transcatheter closure has emerged as an alternative to surgical intervention.
- Controlled-release coils represent a recent advancement in PDA closure devices.
Purpose of the Study:
- To evaluate the safety and efficacy of controlled-release coils for transcatheter closure of PDA.
- To assess procedural success rates, complications, and outcomes in pediatric patients.
Main Methods:
- Transcatheter implantation of controlled-release PDA coils via femoral artery access.
- Procedure performed in 13 patients aged 5 months to 15 years.
- Coil deployment assessed by fluoroscopy and immediate post-procedure echocardiography.
Main Results:
- Successful closure in 10 out of 13 patients.
- Complete occlusion achieved in 9/10 patients immediately post-procedure, and all at follow-up.
- One instance of coil embolization successfully retrieved and reimplanted.
- No major complications like hemorrhage or hemolysis reported.
Conclusions:
- Controlled-release PDA coils are effective and safe for transcatheter closure.
- The procedure demonstrates a high success rate with minimal complications.
- This method is cost-effective and particularly beneficial for underserved regions.
Abstract:
Controlled-release coils have become available recently for the closure of patent ductus arteriosus (PDA). Transcatheter closure of patent arterial ducts was attempted in 13 patients, ranging in age from 5 months to 15 years, mean 4.1 years. Implantation of controlled-release PDA coils was attempted via the femoral artery through 5 Fr catheters in all cases except one, in whom both the femoral arterial and venous routes were used. The procedure was successful in 10 of the 13 patients. In these, the pulmonary artery systolic pressure ranged between 25 and 42 mmHg and the duct diameter varied from 1.5 to 6 mm at its narrowest point. Six of the patients received a single coil. Two coils were inserted in three patients and three coils in one patient. In three patients the ducts were too large for safe release of the coils, despite attempted implantation of up to three coils simultaneously. These coils were easily withdrawn into the catheter. Immediately at the end of the procedure, the duct was completely occluded in nine of the 10 patients, and in one patient there was a small residual flow. The procedure time varied between 35 min and 2.5 h, mean 81 min and the fluoroscopy time varied from 5 to 78 min, mean 25 min. None of the patients experienced hemorrhage, diminished lower extremity pulse, hemolysis or infection. In one patient, a 5 mm coil embolized into the right pulmonary artery soon after release. It was retrieved with a snare, then 8 mm and a 5 mm coil were implanted satisfactorily in the arterial duct. At follow-up by color Doppler echocardiography, the duct was completely occluded in all patients. Transcatheter closure of patent arterial ducts by controlled-release PDA coils is effective and safe. Even when more than one coil is inserted, it is still cheaper than transcatheter umbrella closure. This method is therefore of great value, particularly in less affluent countries.
