Objectives To explore the interventional experience of transcatheter closure of patent ductus arteriosus (PDA) in children with body weight ≤ 8Kg.
Methods From May 2001 to October 2012, 81 children with body weight ≤ 8Kg were diagnosed PDA by X-Ray, EKG and echocardiography. All patients underwent transcatheter closure. Then made aorta descendens angiography 5 minutes after closure. To observe the therapeutic efficacy using X-ray, ECG and echocardiography examination 24 hours after operation.
Results In 81 patients, male 22, female 59, aged from 3 months to 2 years (0.9 ± 0.5 years), body weight from5 to 8 kg (7.2 ± 0.9) kg. The mean PDA diameter of narrowest segment was (4.8 ± 1.5) mm (ranging from 2 to 10 mm) by aortography. 56 patients used domestic-made PDA mushroom occluders, 2 patients used domestic-made VSD occluders, 22 patients used Amplatzer mushroom occluders and 1 patients used Amplatzer Plug. All the delivery catheter diameters were less than or equal to 9F. The mean occluders waist diameter was (8.7 ± 1.8) mm (ranging from 6 to 14 mm). The difference and proportionality of the occluders waist diameter and the narrowest PDA segment was 2∼8 (4.3 ± 1.5) mm and 1.3∼4 (2.1 ± 0.6) mm. 52 patients were all cured successfully. The closure achievement ratio was 100%. Complete angiographic closure was seen 5 min after the device deployment in 77 out of 81 patients (95.1%), while small leaks were presented in 4 cases (4.9%). Complete echocardiographic closure were demonstrated in 81 patients (100%) within 24 hours. There was no PDA recanalisation and migration of devices, erythrocytolysis, infection, Thrombosis and other complications after the complete occlusion during 6 month following up.
Conclusions Catheter closure of children PDA with body weight less than or equal to 8 kg is a safe and effective. There is no difference in using domestic-made mushroom occluders and Amplatzer mushroom occluders. To avoid make injury of venous, the delivery catheter diameters should be less than or equal to 9F. The occluder’s size selection is very important. We should notice to avoid causing the influence of the aorta and pulmonary artery. This research shows that the difference and proportionality of the occluders waist diameter and the narrowest PDA segment was 4∼6 mm and 1.5. The two values can be used as a reference for selecting device size. As the individual differences, we also should pay attention to combine with actual situation to select the device.