Transcatheter Patent Ductus Arteriosus (PDA) Device Closure: Comparative Outcomes Between Conventional Versus Single Vessel Approach

Authors

  • Hajira Akbar Department of Pediatric Cardiology, Armed Forces Institute of Cardiology, Rawalpindi/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-4.14170

Keywords:

Catheterization, Complications, Femoral Vein, Femoral Artery, Patent Ductus Arteriosus, Pediatric, Transcatheter Device Closure.

Abstract

Objective: To determine post procedural outcomes, complications, and effectiveness of transcatheter PDA closure using single-vessel and Conventional Arteriovenous access in pediatric patients.

Study Design: Analytical Cross-Sectional.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, Pakistan; January 2024- December 2025.

Methodology: The study included 269 children with isolated PDA (<12 years, <30 kg) were enrolled. Data were collected retrospectively and prospectively from patients of transcatheter PDA closure. Children with other associated congenital cardiac anomalies, pulmonary hypertension, or PDA-dependent cardiac defects were excluded from the study. Participants were divided into two groups; A and B, where Group A had single vessels and Group B had the conventional arteriovenous approach. Device closures were performed and all metrics pertaining to the procedures, the complications, and the outcomes post procedure were documented.

Results: Transcatheter PDA closure was performed in 269 children using a single vessel approach (Simple Vessel Approach (n=145) and conventional arteriovenous approach (n=124). Baseline age, weight, and PDA size were similar across groups. Fluoroscopy time and contrast volume did not differ significantly. Compression time was longest with femoral arterial access and shortest with the arteriovenous approach, and anticoagulation strategies varied by access route (p<0.001). Most patients were discharged on the first post-procedure day. In-hospital mortality was low (1.5%), and the majority had no complications.

Conclusion: Single vessel approach appears safe and feasible alternatives to conventional arteriovenous access for pediatric PDA closure, with low in-hospital complication rates. Access route selection was significantly associated with device choice.

Downloads

Download data is not yet available.

References

1. Xu J, Li Q, Deng L, Xiong J, Cheng Z, Ye C. Global, regional, and national epidemiology of congenital heart disease in children from 1990 to 2021. Front Cardiovasc Med 2025; 12: 1522644.

http://dx.doi.org/10.3389/fcvm.2025.1522644

2. Ön ŞŞ, Doğan E, Ergin F, Beyter MB, Kayan Kaşıkçı G, Yılmaz M, et al. Transcatheter ductus arteriosus closure with various devices in the pediatric patient group and long-term outcomes: Experience from a single center. J Pediatr Res 2024; 11(4): 207–211. http://dx.doi.org/10.4274/jpr.galenos.2024.69094

3. Marsogi M, Waworuntu DS, Kaunang ED. Profile of cardiac catheterization in children with congenital heart disease in eastern Indonesia. IP Journal of Paediatrics and Nursing Science [Internet]. 2025; 8(1): 17–21. Available from:

https://jpns.in/archive/volume/8/issue/1/article/1762/pdf?utm

4. Begum H, Sadiq N, Anwar S, Hassan A, Ahmed Z, Waqar H et al. Pattern of congenital heart diseases in patients presenting in a tertiary care hospital of Karachi. J Bahria Uni Med Dental Coll. 2025 [cited 2026 Jan 9]; 15(04): 312–7. Available from:

https://jbumdc.bahria.edu.pk/index.php/jbumdc/article/view/272?utm_source=chatgpt.com

5. Lynn S. Evolution of Transvascular Catheter From Material, Construction, and Technological Perspectives. Arterial Treatment of Neurological Diseases: Current Status and Future Directions. 2025; 267–297.

https://doi.org/10.1007/978-3-031-80173-0_18

6. Uppal L, Rohit MK, Barwad P, Naganur S, Debi U, Kasinadhuni G, et al. Comparison of isolated venous approach with the standard approach in children undergoing patent ductus arteriosus device closure. Egypt Heart J 2020; 72(1): 65.

http://dx.doi.org/10.1186/s43044-020-00100-1

7. Ye Z, Li Z, Yi H, Zhu Y, Sun Y, Li P, et al. Percutaneous device closure of pediatirc patent ductus arteriosus through femoral artery guidance by transthoracic echocardiography without radiation and contrast agents. J Cardiothorac Surg. 2020; 15(1): 107. http://dx.doi.org/10.1186/s13019-020-01119-w

8. Toizumi M, Do CGT, Motomura H, Do TN, Fukunaga H, Iijima M, et al. Characteristics of patent ductus arteriosus in congenital rubella syndrome. Sci Rep [Internet]. 2019; 9(1): 17105.

http://dx.doi.org/10.1038/s41598-019-52936-6

9. Zhou Z, Gu Y, Zheng H, Li S, Xu L, Liu Q, et al. Transcatheter closure of patent ductus arteriosus via different approaches. Front Cardiovasc Med 2021; 8: 797905.

http://dx.doi.org/10.3389/fcvm.2021.797905

10. Liu J, Gao L, Tan H-L, Zheng Q-H, Liu L, Wang Z et al. Transcatheter closure through single venous approach for young children with patent ductus arteriosus: A retrospective study of 686 cases: A retrospective study of 686 cases. Medicine (Baltimore) 2018; 97(35): e11958.

http://dx.doi.org/10.1097/MD.0000000000011958

11. Garg R, Zahn E, Sathanandam S, Johnson JN. Transcatheter patent ductus arteriosus closure in extremely premature infants. Prog Pediatr Cardiol 2021; 61(101366): 101366.

http://dx.doi.org/10.1016/j.ppedcard.2021.101366

12. Kanwal A, Sheikh AM, Akbar T, Sehar T, Sheikh KA, Talat S. Venous-only transcatheter closure: A safe and effective strategy for patent ductus arteriosus. Pak Hear J 2024 [cited 2025 Dec 10];57(1):29–32. https://pakheartjournal.com/index.php/pk/article/view/2652

13. Dietrich A, Quandt D, Kretschmar O, Knirsch W. Immediate and long-term results of transcatheter closure of patent ductus arteriosus-Comparison of two decades before and after change in antibiotic infective endocarditis prophylaxis guidelines. Congenital heart disease 2022; 17: 215–230.

https://doi.org/10.32604/chd.2021.017232

14. Harinarayanan SC, Wu S, Arar Y, Zellers TM, Veeram Reddy SR, Divekar AA. Venous-only approach for transcatheter patent ductus arteriosus closure in infants: Is it time for change? J Soc Cardiovasc Angiogr Interv 2025; 4(8): 103735.

http://dx.doi.org/10.1016/j.jscai.2025.103735

15. Xiong P, Chen Q, He Y. Application of single venous approach under echocardiography without angiography in closure of Patent Ductus Arteriosus. J Cardiothorac Surg 2024; 19(1): 676.

http://dx.doi.org/10.1186/s13019-024-03143-6

16. Choudary TA, Youns M, Beg M. Maqbol B: Challenges in device closure of PDA (Patent Ductus Arteriosus) in adults. Prof. Med. J. 2022. 2022; 0129: 71–76.

https://doi.org/10.29309/TPMJ/2022.29.01.6381

17. Ibrahim WA, El-Emam AM, Hamdy MG, Lasheen SS: Techniques and outcomes of patent ductus arteriosus transcatheter closure: Comparison between adult and pediatric patients. Egypt J Hosp Med 2025; 100(1): 3605–3612.

http://dx.doi.org/10.21608/ejhm.2025.446898

18. Yasuhara J, Kuno T, Kumamoto T, Kojima T, Shimizu H, Yoshiba S, et al. Comparison of transcatheter patent ductus arteriosus closure between children and adults. Heart Vessels. 2020; 35(11): 1605–1613.

http://dx.doi.org/10.1007/s00380-020-01639-4

Downloads

Published

22-05-2026

Issue

Section

Original Articles

Categories

How to Cite

1.
Akbar H. Transcatheter Patent Ductus Arteriosus (PDA) Device Closure: Comparative Outcomes Between Conventional Versus Single Vessel Approach. Pak Armed Forces Med J [Internet]. 2026 May 22 [cited 2026 Jun. 11];76(SUPPL-4):S696-S701. Available from: https://pafmj.org/PAFMJ/article/view/14170