Transcatheter closure through single venous approach for young children with patent ductus arteriosus A retrospective study of 686 cases

Abstract

The objective is to explore the feasibility and safety of transcatheter closure of patent ductus arteriosus (PDA) through single venous approach in Chinese young children. A total of 1088 patients aged between 9 months old to 3 years old who underwent transcatheter closure of PDA from May 2004 to May 2015 were retrospectively reviewed. All the procedures were under ultrasound monitoring. The shape and size of PDA as well as immediate therapeutic results were recorded by angiography and ultrasonography. The size of occluder was individually selected according to the smallest diameter of the PDAs. Echocardiography was respectively performed 3 days, 1month, 6 months, and 12 months after the procedure to evaluate the outcomes. Among the total 1088 children, transcatheter closure of PDA was accomplished through single venous approach that was performed in 686 cases. The average weight and age of the children were 10.9±3.6kg (5.0-14.3 kg) and 1.8±1.6 years (9 months- 3 years), respectively. The fluoroscopic time was about 5.1 to 11.6 minutes. Successful device placement with the initially selected occluder was achieved in 662 cases. In other 14 cases, the procedure was eventually completed after being replaced with a larger occluder; while in the other 10 cases, smaller occluders were applied to replace the initial ones. Technically, all the procedures were successfully performed. All the patients were followed up for 15.6±8.2 years. No serious complications and death were observed during the follow-up. Transcatheter closure of PDA with occluder by single venous approach is an effective and reliable method in vast majority of young children.