Device closure of patent ductus arteriosus: analysis of cases in a Bangladeshi centre

Background: Transcatheter closure of Patent ductus arteriosus (PDA) has become the first-choice therapy for closure in patients of any age group. Authors reviewed the outcome of device closure in all age groups starting from neonate to adult.Methods: From December 2014 to December 2019, 440 cases underwent transcatheter closure in a catheterization laboratory of a tertiary level cardiac hospital. Selection criteria were isolated PDA or PDA with associated conditions which can be managed in the same setting by an intervention. Exclusion criteria were proven Eisenmenger syndrome. A retrospective review of outcome and complications were recorded from computerized data records.Results: Age of the patient varied from 10 days to 65 years. The median age was 3 years. Most of the patients were female (63%), weight varied from 1.8 kg to 75 kg. the median weight was 7.5 kg. Isolated PDA cases were 74.77 %. Among syndromes, congenital rubella syndrome was common (7.5%), followed by Down Syndrome (6.36%). The narrowest PDA diameter varied for 1.8 mm - 14 mm with a median of 5 mm. Among duct occluders, 8x6 mm CeraTM was the commonest one used in the study population. Complete occlusion was observed in 99.55% of cases.Conclusions: Transcatheter closure of PDA is considered safe and efficacious in all age groups. It is the gold standard now and replaced surgical option in most of the places.

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Intravascular ultrasonography-guided measurement and transcatheter closure of highly calcified patent ductus arteriosus in an older adult

Cardiology in the Young ◽

10.1017/s1047951121002250 ◽

2021 ◽

pp. 1-3

Author(s):

Yoko Kawai ◽

Takeshi Nakamura ◽

Satoaki Matoba

Keyword(s):

Older Adults ◽

Patent Ductus Arteriosus ◽

Older Adult ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Ct Images ◽

Device Closure ◽

Intravascular Ultrasonography ◽

Patent Ductus

Abstract In older adults with patent ductus arteriosus, CT is widely used for duct visualisation because angiography images can be inadequate for evaluation. We report the case of a 73-year-old woman with a highly calcified patent ductus arteriosus whose CT images were insufficient for accurate measurement. Intravascular ultrasonography is useful for sizing of and guiding device closure of the duct.

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Safety and Procedural Success of Transcatheter Closure of Patent Ductus Arteriosus in Adults at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Nepalese Heart Journal ◽

10.3126/njh.v17i2.32679 ◽

2020 ◽

Vol 17 (2) ◽

pp. 43-46

Author(s):

Chandra Mani Adhikari ◽

Amrit Bogati ◽

Kiran Prasad Acharya ◽

Manish Shrestha ◽

Urmila Shakya ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Adult Patients ◽

Device Closure ◽

Cardiac Catheterization Laboratory ◽

National Heart ◽

Procedural Success ◽

Device Size ◽

Patent Ductus

Background and Aims: Transcatheter closure of patent ductus arteriosus (PDA) using either coils or device is a well-established procedure. PDA is one of the common congenital heart diseases and it is not uncommon for it to be diagnosed in adulthood. However, only few studies are conducted in our part of the world regarding the safety and procedural success of device closure of PDA in adults. We aim to assess safety and procedural success of transcatheter closure of PDA in adults at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. Methods: It was a single center, retrospective study. Cardiac catheterization laboratory records of all consecutive adult patients (age ≥ 18 years) who underwent PDA device closure between March 2007 to March 2020 were reviewed. Patients age, gender, device size and device type along with procedural success of the procedure were reviewed. Any complication recorded was reviewed. Results: During the study period 118 adult patients were attempted for transcatheter closure of PDA. In three cases transcatheter closure was not attempted. In one patients attempt was made to close the duct with cook coil which embolized to pulmonary artery. PDA was successfully closed in 114 patients. Among the 114 patients, 87 were females and 27 were male. Age ranged from 18 to 69 years with mean age was 29.5 years. PDA size ranged from 3mm to 18mm with the mean of 6.9mm. In two patients, residual PDA after surgical closure were closed. Amplatzer duct occluder was the most commonly used device used in 89 (78%) patients followed by Memopart PDA device in 11 (9.6%) patients, Amplatzer Muscular VSD occluder in four patients. Device size of “8x10” in 32 patients and “10x12” device in 29 patients, were the most commonly used device size. Conclusion: Transcatheter closure of PDA in adults can safely be done with high success rate.

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Hemolysis and its outcome following percutaneous closure of cardiac defects among children and adolescents: a prospective study

Italian Journal of Pediatrics ◽

10.1186/s13052-019-0728-5 ◽

2019 ◽

Vol 45 (1) ◽

Author(s):

Hamid Amoozgar ◽

Romeileh Soltani ◽

Mohammadreza Edraki ◽

Nima Mehdizadegan ◽

Hamid Mohammadi ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Patent Ductus Arteriosus ◽

Septal Defect ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Residual Flow ◽

Intravascular Hemolysis ◽

Device Closure ◽

Residual Shunt ◽

Patent Ductus

Abstract Background Transcatheter closure of intracardiac defects might be complicated by intravascular hemolysis. We evaluated hemolysis and its outcome after transcatheter closure of these defects. Methods and patients All patients who underwent transcatheter closure of patent ductus arteriosus, ventricular septal defect and atrial septal defect were included in this prospective study. Clinical data were obtained before and after the catheterization. Results One hundred and thirty-eight patients were enrolled; and four (3%) patients developed intravascular hemolysis; while two cases had residual shunt and two other cases had not residual flow. Although residual shunt occurred in ten patients, only 2 of these cases developed hemolysis. Patent ductus arteriosus closure was done for one of these cases and the other one, underwent perimembranous ventricular septal defect closure. Moreover, hemolysis occurred after device closure of patent ductus arteriosus in 2 of the other patients with no residual shunt. In this study the hemolysis was eliminated by conservative management within 2 weeks although residual shunt continued in this time. We observed a decline in lactate dehydrogenase value after catheterization in comparison with precatheterization, which was mainly among ventricular septal defect patients that might be due to mild chronic hemolysis in these patients. Conclusion Incidence of hemolysis after device closure was low, and occurred with and without residual flow and was eliminated by conservative management in 2 weeks, without the need for surgery, although the residual shunt was continued.

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Ductal arterial spasm: a nightmare

Cardiology in the Young ◽

10.1017/s1047951119003238 ◽

2020 ◽

Vol 30 (3) ◽

pp. 422-423

Author(s):

Hnin L. Phyu ◽

Khin M. Oo

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Catheter Intervention ◽

Device Closure ◽

Arterial Spasm ◽

Percutaneous Device ◽

Device Selection ◽

Percutaneous Device Closure ◽

Patent Ductus

AbstractDuctal arterial spasm is a very potentially dangerous incidence during percutaneous device closure of patent ductus arteriosus (PDA), which, otherwise, is a very safe catheter intervention. It is essential to notice its occurrence before device sizing and deploying. Without awareness, it can mislead device selection and can result in serious complication. In this report, we shared our nightmare of ductal spasm during transcatheter closure of PDA in two children which had led to death in one patient.

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Characteristics of Patent Ductus Arteriosus in Congenital Rubella Syndrome

Scientific Reports ◽

10.1038/s41598-019-52936-6 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Michiko Toizumi ◽

Cam Giang T. Do ◽

Hideki Motomura ◽

Tin N. Do ◽

Hirofumi Fukunaga ◽

...

Keyword(s):

Aortic Stenosis ◽

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Congenital Rubella Syndrome ◽

Systemic Hypertension ◽

Cardiac Complications ◽

Tubular Type ◽

Congenital Rubella ◽

Patent Ductus

AbstractThis study investigated the characteristics of congenital rubella syndrome (CRS)-associated cardiac complications, particularly patent ductus arteriosus (PDA). We reviewed the medical records of patients with CRS who were admitted to the Children’s Hospital 1 in Vietnam between December 2010 and December 2012, and patients with CRS who underwent PDA transcatheter occlusion therapy at the cardiology department between December 2009 and December 2015. We compared the characteristics of PDA treated with transcatheter closure between children with CRS (CRS-PDA) and those without CRS (non-CRS-PDA) who underwent PDA transcatheter closure between July 2014 and December 2015. One-hundred-and-eight children with CRS were enrolled. Cardiac defects (99%), cataracts (72%), and hearing impairment (7%) were detected. Fifty CRS-PDA and 290 non-CRS-PDA patients were examined. CRS-PDA patients had smaller median birthweight (p < 0.001), more frequent pulmonary (p < 0.001) and aortic stenosis (p < 0.001), higher main pulmonary artery pressure, and higher aortic pressure in systole/diastole (p < 0.001 for each) than did non-CRS-PDA patients. The proportion of tubular-type PDA was higher in CRS-PDA patients (16%) than in non-CRS-PDA patients (3%) (p = 0.020). Tubular-type PDA was frequently seen in patients with CRS and accompanied by pulmonary/systemic hypertension and pulmonary/aortic stenosis; in these patients, more cautious device selection is needed for transcatheter PDA closure.

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Transcatheter closure of Patent ductus arteriosus at Shahid Gangalal National Heart Centre, Kathmandu, Nepal

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v6i1.18310 ◽

2017 ◽

Vol 6 (1) ◽

pp. 1-3

Author(s):

Chandra Mani Adhikari ◽

Rabi Malla ◽

Urmila Shakya ◽

Manish Shrestha ◽

Binay Rauniyar ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Lateral View ◽

Catheterization Laboratory ◽

Transcatheter Occlusion ◽

Cardiac Catheterization Laboratory ◽

National Heart ◽

Device Deployment ◽

Patent Ductus

Background and Aims: In the current era, transcatheter closure of patent ductus arteriosus (PDA) using either coils or device is a well-established procedure. The aim of this study was to assess safety of transcatheter closure of PDA at Shahid Gangalal national heart Centre, Kathmandu, Nepal.Methods: It was a single centre, retrospective study conducted between March 2007 to March 2017. Cardiac catheterization laboratory records of all consecutive patients who underwent PDA device closure were included. A lateral view Aortic angiogram was performed to determine the morphology and size of the duct. Device type and size was selected as per the aortogram. A second aortic angiogram was performed 5 min after device deployment to determine the success of the closure. Echocardiography was done next day of the procedure to assess success of the closure.Result: During the study period 126 patients were attempted for transcatheter closure of PDA. Six patient were thought to have unfavorable size or shape, and transcatheter occlusion was not attempted. In one patients attempt was made to close the duct with cook coil which embolized to pulmonary artery. One hundred and nineteen patient PDA was successfully closed. Among the 119 patients 89 were female and 30 were male. The PDA was closed by Amplatzer duct occluder in 99 patients, Life tech PDA occluder in 14 patients, Hyperion PDA occluder in two patients, Post-infarct Muscular VSD Occluder in four patients.Conclusions: Transcatheter closure of PDA can be done safely with high success rate.

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Intravascular Hemolysis after Transcatheter Closure of a Huge Tubular Patent Ductus Arteriosus Using Cera-duct Occluder: Managed Successfully by Conservative Treatment

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v16i2.55309 ◽

2021 ◽

Vol 16 (2) ◽

pp. 90-92

Author(s):

Md Ferdousur Rahman Sarker ◽

Nurun Nahar Fatema Begum ◽

Jannatul Ferdous ◽

Nazmul Islam Bhuiyan ◽

Md Ashfaque Ahemmed Khan ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Transcatheter Closure ◽

Ductus Arteriosus ◽

Growth Failure ◽

Female Child ◽

Intravascular Hemolysis ◽

Device Closure ◽

History Of ◽

Transcatheter Device ◽

Patent Ductus

Isolated patent ductus arteriosus (PDA) is seen in approximately 1 in 2000 full-term life birth neonate. Transcatheter device closure is widely considered as the treatment of choice for the patient diagnosed with PDA considering the safety, efficacy and less invasiveness. Residual flow following transcatheter device closure of PDA can result in haemolysis. Our patient was a case of 9.5 years old female child weighing13 kg diagnosed as a case of large tubular PDA with severe pulmonary hypertension by echocardiography. The patient had history of recurrent chest infection, breathlessness on exertion, and growth failure. The PDA was closed by transcatheter approach using Cera-duct occluder. The patient subsequently developed hemolysis which started 18 hrs after the intervention and the resolution of hemolysis achieved by conservative management within 72 hours. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 90-92

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