Open AccessSafety of Percutaneous Patent Ductus Arteriosus Closure: An Unselected Multicenter Population Experience
Author(s) -
ElSaid Howaida G.,
Bratincsak Andras,
Foerster Susan R.,
Murphy Joshua J.,
Vincent Julie,
Holzer Ralf,
Porras Diego,
Moore John,
Bergersen Lisa
Publication year - 2013
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.113.000424
Subject(s) - medicine , ductus arteriosus , percutaneous , multicenter study , adverse effect , cardiac catheterization , surgery , population , cardiology , randomized controlled trial , environmental health
Background The technique and safety of transcatheter patent ductus arteriosus ( PDA ) closure have evolved during the past 20 years. We sought to report a multicenter experience of PDA closure with a focus on the rate of adverse events ( AE ) and a review of institutional practice differences. Methods and Results Outcome data on transcatheter PDA closure were collected at 8 centers prospectively using a multicenter registry (Congenital Cardiac Catheterization Project on Outcome Registry). Between February 2007 and June 2010, 496 PDA closures were recorded using a device in 338 (68%) or coils in 158 (32%). Most patients had an isolated PDA (90%). Fifty percent of patients were between 6 months and 3 years old, with only 40 patients (8%) <6 months old. Median minimum PDA diameter was 2.5 mm (range 1 to 12 mm; IQR 2 to 3 mm) for device closure and 1 mm (range 0.5 to 6 mm; IQR 1 to 2 mm) for coil closure ( P <0.001). A device rather than coil was used in patients <3 years, weight <11 kg, and with a PDA minimum diameter >2 mm (all P <0.001). Three of 8 centers exclusively used a device for PDA s with a diameter >1.5 mm. In 9% of cases (n=46), an AE occurred; however, only 11 (2%) were classified as high severity. Younger age was associated with a higher AE rate. Coil‐related AE s were more common than device‐related AE s (10% versus 2%, P <0.001). Conclusions PDA closure in the present era has a very low rate of complications, although these are higher in younger children. Technical intervention‐related events were more common in coil procedures compared with device procedures. For PDA s ≤2.5 mm in diameter, institutional differences in preference for device versus coil exist.