Lung perfusion studies after detachable coil occlusion of persistent arterial duct
N Sreerama, M Tofeigb, K P Walshb, P Huttera
a Department of
Cardiology, Wilhelmina Children's Hospital, ABC Straat, 3501 CA
Utrecht, Netherlands, b Royal Liverpool Children's Hospital, Liverpool,
UK
Correspondence to: Dr Sreeram email: nsreeram{at}azu.ruu.nl
Accepted for publication 24 September 1998
OBJECTIVE
To
evaluate relative lung perfusion following complete occlusion of
persistent arterial duct with detachable Cook coils.
METHODSDuctal
occlusion using detachable coils was performed in 35 patients (median
age 3.9 years, range 0.5 to 16; 32 native ducts, three patients with
previous devices). If the duct could be crossed with a 0.035 inch
guidewire and a 4 F catheter after coil implantation, a further coil
was implanted. Between one and seven coils were used (median two).
RESULTSComplete
ductal occlusion was confirmed by echocardiography 24 hours after the
procedure in all patients. Lung perfusion scans were performed three
months after the procedure in 33 of 35 patients (two older patients
with a single coil each did not attend). Decreased perfusion to the
left lung (defined as < 40% of total lung flow) was observed in only
one patient, who had previously had a 17 mm Rashkind umbrella
implanted. There was no correlation between left lung perfusion and
peak left pulmonary artery Doppler velocities (r = 0.27 and p = 0.125 for the entire
group; r = 0.29 and p = 0.124 after
excluding patients with previous devices).
CONCLUSIONSCoil
occlusion is effective in achieving complete closure of the duct. An
aggressive approach using multiple coils did not compromise perfusion
to the left lung.
Keywords: arterial duct; coil occlusion; lung perfusion
© 1999 by Heart
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