PATENT DUCTUS ARTERIOSUS DEVICE OCCLUSION

IMMEDIATE RESULTS AND COMPLICATIONS.

Abstract

Objectives: To determine immediate outcomes and complication rate of
transcatheter closure of patent ductus arteriosus. Study Design: Retrospective analysis.
Setting: CPE Institute of cardiology. Period: 2009 to May 2016. Materials and Methods:
Two hundred and seventy four (274) results of transcatheter occlusion of PDA performed by
pediatric cardiologists. All patients who underwent PDA occlusion regardless of their weight
either by ADO device or SHSMA occlude were included for analysis. SPSS V23 was used for
data processing. Frequency was calculated for qualitative variables and mean for quantitative
ones. Results: The mean age of study participants was 9.57+8.82 years. There was female
predominance with 65.7% females and 34.3% males. Regarding severity of PDA, 90 (32.8%)
patients were presented with large PDA, 70 (25.5%) with moderately large PDA, 107 (39.1%)
with moderate PDA and only 6 (2.2%) were presented with small sized PDA. Classical conical
shaped PDA was most common manifestation, diagnosed in 66.8% patients and long ampulla
shaped in 70 (25.5%) patients. Regarding complications, device embolization occurred in one
patient. Residual PDA in catheterization lab was present in 4 (1.5%) patients. Radial pulse loss
occurred in 6 (2.2%) patients for which heparin infusion was started until the pulse became
palpable. Blood transfusion was required in 3 (1.1%) patients due to excessive blood loss
during the procedure. Mild left pulmonary artery obstruction due to protrusion of pulmonary
end of device occurred in 2 (0.7%) patients. Device protrusion into aorta was noted in only 16
(5.8%), in all of these patients there was no aortic flow obstruction. Overall success rate was
99.63%. There was no procedure related mortality. Conclusion: Percutaneous patent ductus
arteriosus closure is safe with minimum number of complications. Pulse loss, protrusion o aortic
end of device into aorta and residual PDA in cath lab (resolved within 24 hours) are common
procedural complications.