Balloon occlusion delivery technique for closure of patent ductus arteriosus,☆☆,

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METHODS

Appropriate informed consent for cardiac catheterization, angiography, and PDA coil occlusion was obtained from all patients or parents of patients. The patients either underwent general anesthesia or intravenous sedation according to institutional guidelines.

. Patient data

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Age1 mo3 mo8 mo6 mo7 mo1 yr1 yr2 yr4 yr5 yr7 yr8 yr10 yr11 yr21 yr49 yr
Weight (kg)3.855.667.29.49.413.41718233336384768
PDA size (mm)2.52.91.942.522.92.21.94.63.12.6433.54.3
PDA typeAEEABBABAABAAABB
Fluoro

RESULTS

Sixteen patients (11 female and five male) underwent PDA occlusion with this technique. Age ranged from 1 month to 49 years, and weight ranged from 3.8 kg to 68 kg (19.4 ± 18 kg). All patients had a continuous murmur, and two had clinical congestive heart failure. A 10-year-old patient had a previously unsuccessful attempt at PDA occlusion (this patient has been previously reported). 2 All patients except one were discharged on the day of the procedure. No complications such as embolizations or

DISCUSSION

In this series of 16 patients the balloon occlusion delivery technique enabled accurate placement of coils for PDA closure in every case. This technique is helpful in avoiding coil embolization by decreasing the kinetic energy at release, thereby decreasing the chance of dislodging the coil at discharge from the catheter. In addition, the technique allows the coil loops to group together in a mass that plugs the aortic diverticulum versus having a length of coil pass into the pulmonary artery

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Cited by (33)

  • Comparison of two transcatheter closure methods of persistently patent arterial duct

    2001, American Journal of Cardiology
    Citation Excerpt :

    Our lower coil occlusion rates in part may be due to the implantation protocol used in this trial, requiring that >1 coil be implanted only if dense opacification of the pulmonary artery was seen on hand injection contrast. Furthermore, we did not employ techniques to specifically avoid coil embolization, such as the use of detachable coils, the use of a nitinol snare16 or forceps,17 or a balloon occlusion technique.18,19 The rationale for the conservative coil implantation protocol evolved from our previous experience with the Rashkind device, where long-term follow-up noted a proportion of early residual leaks that resolved with time.10,20

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Reprint requests: Farhouch Berdjis, MD, Division of Cardiology, Children's Hospital of Orange County, 455 S. Main St., Orange, CA 92268

☆☆

Am Heart J 1997;133:601-4.

0002-8703/97/$5.00 + 0 4/1/80082

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