Abstract

Cierre percutáneo del ductus arterioso permeable: Siete años de experiencia. Arch. Pediatr. Urug. [online]. 2003, vol.74, n.3, pp.187-196. ISSN 1688-1249.

Summary Objective: the study analizes the immediate results and medium term follow-up after percutaneous closure of the patent ductus arteriosus (PDA) in patients referred to a national pediatric cardiology center. Patients and methods: 138 patients (age 3 months-40 years, mean 3 years) were considered for transcatheter closure of a PDA during a seven year period. The transarterial approach was employed in 97% of procedures, to deliver occluder devices and try to achieve closure of the PDA. Gianturco coils were employed in all but two patients (one was treated with a Grifka bag, the other with Amplatzer duct occluder). Immediate results were based on aortography and residual shunts evaluated at follow-up with color flow Doppler. Results: complete inmediate closure was achieved in 66%. A small residual shunt was observed in 16,6%; spontaneous closure occurred in all except 3 patients lost to follow up. Patients who had significant residual shunts required a second procedure to obtain complete closure (5,8%). Failure to implant a coil occurred in relation to 4 mm or larger diameter and/or tubular morphology (11,6%). In all, 86% of the patients had no residual shunts at medium term follow-up. Embolized coils in the pulmonary circulation could not be retrieved in three patients, with no clinical problems. In one patient a femoral arteriotomy was required to retrieve a coil. Conclusions: percutanous closure of the PDA is effective and safe. It is feasible in most postneonatal patients with this anomaly, if one has access to all types of presently existing devices

Keywords : DUCTUS ARTERIOSUS-surgery.

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