Open AccessTranscatheter closure of the patent ductus arteriosus in adults using the gianturco coil
Author(s) -
Ing Frank F.,
Muluns Charles E.,
Rose Marion,
Shapir Yehuda,
Bierman Fredrick Z.
Publication year - 1996
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960191107
Subject(s) - medicine , ductus arteriosus , percutaneous , occlusion , surgery , left pulmonary artery , local anesthesia , cardiac catheterization , stenosis , thoracotomy , pulmonary artery , anesthesia , cardiology
Background and hypothesis: Although results of surgical ligation of the patent ductus arteriosus (PDA) in the pediatric age group are excellent, surgical management of the adult with a PDA may be more problematic. The PDA that presents in adulthood may be calcified and friable, rendering simple ligation via a thoracotomy difficult, inadequate, and hazardous. Patch closure of the ductus arteriosus from either the aortic or pulmonary artery orifice using cardiopulmonary bypass or transient aortic cross‐clamping is necessary but increases surgical risks. Furthermore, older patients with diseases unrelated to their PDA and patients with Down's syndrome may have higher risks with intubation, general anesthesia, and surgery. Early results of percutaneous transcatheter occlusion of the PDA with Gianturco coils performed under sedation and local anesthesia are promising. Methods: Six adults with mean age of 39.1 years (range 23.1–62.0 years) were found to have an isolated PDA with mean minimum diameter of 2.7 mm (range 1.0–5.0 mm) at cardiac catheterization. All underwent percutaneous transcatheter occulsion of the PDA using Gianturco coils. Results: Coil implantation was successful in all patients. There were no complications and all were discharged home within 24 hours. Complete ductal occlusion was seen immediately in 4 of 6 patients (67%) while 2 of 6 (33%) had small residual leaks. However, complete occlusion was achieved in all patients by 6 months following the procedure. Conclusion: Transcatheter occlusion of the PDA using coils is safe and efficacious in adults.