TECHNICAL CONSIDERATIONS AND CHALLENGES ENCOUNTERED DURING TRANSCATHETER OCCLUSION OF DUCTUS IN INFANTS

Abstract

Objective: To focus on the results and the difficulties confronted by the interventionist during therapeutic
occlusion of ducts in very small babies and share the experience by using specific devices of specific brands.
Study Design: Retrospective analytical study
Place and Duration of Study: The study was carried out at Army Cardiac Center Lahore from May 2014 to
May 2015.
Material and Methods: A total of 9 infants with patent ductus arteriosus (PDA) with variable sizes and shapes
were included in this study. All the patients were selected in outpatient department and the diagnosis was
confirmed by transthoracic echocardiography
Results: All patients (n=9) had successful closure and included 3 females and 6 males. The weight of the
babies ranged from 4-9 kg with a mean of 6.31kg. The minimum angiographic diameter of the PDAs occluded
was 1 mm and the maximum was 7 mm with a mean of 3mm. Smallest PDA device occluder used was
Occlutech 5-3.5 and the largest size was an ADO1 10-8. We were able to achieve 100% ductal occlusion
confirmed on discharge echo color flow Doppler performed 24 hours later. There was no major complication
like device embolization, limb ischemia, hemolysis and left pulmonary artery stenosis.
Conclusion: Percutaneous device closure of PDA in infants can be accomplished with minimal complications
provided the experience gained in deployment, the basic acquaintance on the pros and cons of the various
devices and the odds of ending up with likely complications is familiar to the primary operator.