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Revista Uruguaya de Cardiología
versión On-line ISSN 1688-0420
Resumen
CHIESA, PEDRO et al. Diez años de experiencia en el cierre percutáneo de la comunicación interauricular y del ductus arterioso persistente. Rev.Urug.Cardiol. [online]. 2008, vol.23, n.1, pp.5-14. ISSN 1688-0420.
SUMMARY The closure of atrial septal defects (ASD) of the ostium secundum (OS) type and patent ductus arteriosus (PDA), once exclusive to the surgery field, requires a careful evaluation of both surgical and percutaneous approaches, considering “risks vs. benefits”. Our ten-year experience in percutaneous closure of such defects in two patient populations is shown: a) 75 patients with ASD (16 months to 56 years old and 8,5 kg minimum weight). In 72 cases the closure was complete, (one patient with minimal mitral valve regurgitation and another with immediate post-procedural hemiparesia, both transitory and without sequelae). In 3 patients the closure could not be accomplished and the devices had to be removed. b) 275 patients with PDA (2 months to 54 years old and weighing from 3,2 to 79 kg). Closure with coils was effective in 86.8% and failed in 10% (surgery required). In 2,2% a mild residual shunt persisted, and 1% were lost for follow-up. With Grifka and Amplatzer PDA devices we reached a 100% success rate. Coil embolization toward the pulmonary and aorta arteries occurred. Coil extraction was effective in all but 3, which were left in place in the peripheral pulmonary branches. No complications with the Amplatzer devices were seen. ASD and PDA percutaneous treatment with occlusive devices, in carefully selected patients, is a simple, practical and effective procedure, which implies a short hospitalization time and minimal psychophysical aggression.
Palabras clave : HEART CATHETERIZATION; INTERVENTIONAL CATHETERIZATION; PATENT DUCTUS ARTERIOSUS; HEART SEPTAL DEFECTS, ATRIAL; BLOOD VESSEL PROSTHESIS; IMPLANTATION.