Balloon occlusion delivery technique for closure of patent ductus arteriosus☆,☆☆,★
Section snippets
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.
Empty Cell 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Age 1 mo 3 mo 8 mo 6 mo 7 mo 1 yr 1 yr 2 yr 4 yr 5 yr 7 yr 8 yr 10 yr 11 yr 21 yr 49 yr Weight (kg) 3.8 5 5.6 6 7.2 9.4 9.4 13.4 17 18 23 33 36 38 47 68 PDA size (mm) 2.5 2.9 1.9 4 2.5 2 2.9 2.2 1.9 4.6 3.1 2.6 4 3 3.5 4.3 PDA type A E E A B B A B A A B A A A B B 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
References (7)
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Percutaneous closure of the small (<2.5 mm) patent ductus arteriosus using coil embolization
Am J Cardiol
(1992) - et al.
Percutaneous closure of the small patent ductus arteriosus using occluding spring coils
J Am Coll Cardiol
(1994) - et al.
Results of anterograde transcatheter closure of patent ductus arteriosus using single or multiple Gianturco coils
Am J Cardiol
(1994)
Cited by (33)
The arterial duct: Its persistence and its patency
2010, Paediatric CardiologyThe Arterial Duct: Its Persistence and Its Patency
2009, Paediatric CardiologyTranscatheter Interventions in Adult Congenital Heart Disease
2008, Congenital Heart Disease in AdultsA strategic approach to transcatheter closure of patent ductus: Gianturco coils for small-to-moderate ductus and Amplatzer duct occluder for large ductus
2006, International Journal of CardiologyOutcome of percutaneous transarterial coil occlusion in patients with isolated patent ductus arteriosus using an upstream-and-push maneuver
2006, Journal of the Formosan Medical AssociationComparison of two transcatheter closure methods of persistently patent arterial duct
2001, American Journal of CardiologyCitation 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
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Am Heart J 1997;133:601-4.
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0002-8703/97/$5.00 + 0 4/1/80082