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[Closure of the persistent ductus with detachable coils]
A Beitzke1, A Gamillscheg, J I Stein
1Klinische Abteilung für Kardiologie, Universitätsklinik für Kinder- und Jugendheilkunde, Graz, Osterreich.
Insights
Transcatheter coil embolization effectively closes patent ductus arteriosus in pediatric patients. This safe and cost-effective procedure offers significant advantages over surgical intervention for duct closure.
Area of Science:
- Cardiology
- Pediatric cardiology
- Interventional cardiology
Context:
- Patent ductus arteriosus (PDA) is a common congenital heart defect in children.
- Transcatheter closure is an alternative to surgical ligation.
- Detachable coils offer a minimally invasive approach for PDA occlusion.
Purpose:
- To evaluate the safety and efficacy of transcatheter occlusion of patent ductus arteriosus using detachable coils in pediatric patients.
- To assess closure rates and complications associated with the procedure.
Summary:
- 34 pediatric patients (3 months-20 years) with PDA underwent transcatheter occlusion with detachable coils.
- High closure rates were achieved: 93% within 24 hours and 94% at 6 months.
- The procedure demonstrated no complications, utilizing arterial and/or venous access with 1-3 coils.
Impact:
- Transcatheter coil embolization is a quick, safe, and cost-effective method for PDA closure in children.
- This technique presents clear advantages compared to surgical PDA ligation.
- The findings support coil embolization as a preferred treatment option for selected pediatric PDA cases.
Abstract:
34 patients aged 3 months to 20 years underwent transcatheter-occlusion of their patent ductus arteriosus with detachable coils (Cook). Eight patients had a residual ductus after previous implantation of a Rashkind-occluder; 7 patients had various other cardiac malformations in addition. Only 6 patients had a large ductus with a diameter between 3 and 4 mm; all had systolic-diastolic murmurs. All other patients had ductus-diameters below 3 mm; three of them had systolic-diastolic murmurs, 17 had systolic murmurs, and 8 patients had no murmur at all. The ductus was closed in 24 patients using arterial access only, in 6 patients via a venous, and in 4 patients both via venous and arterial catheterization. One coil was used in 23 patients, 2 coils in 9, and 3 coils in 2 patients. There were no complications of the intervention. Within 24 hours 31 patients (93%) had complete closure of the ductus and 32 patients (94%) after 6 months. Coil-embolisation of the persistent ductus is a quick, safe and cheap method to close a ductus and has clear advantages compared to an operation.
