open access

Vol 65, No 2 (2007)
Other
Published online: 2007-02-23
Submitted: 2012-12-28
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Original article
Percutaneous closure of recanalised ductus arteriosus – a single-centre experience

Jacek Kusa, Małgorzata Szkutnik, Jacek Baranowski, Eloa Adams, Blandyna Karwot, Jarosław Rycaj, Ireneusz Haponiuk, Jacek Białkowski
Kardiol Pol 2007;65(2):125-129.

open access

Vol 65, No 2 (2007)
Other
Published online: 2007-02-23
Submitted: 2012-12-28

Abstract


Introduction: Restoration of blood flow through a previously occluded ductus arteriosus may occur in some patients. Treatment strategy in patients with such residual shunts has not yet been uniformly established.
Aim: To present single-centre experience and to attempt to establish a strategy of management of patients with residual ductus arteriosus shunts following percutaneous closure.
Methods: Of 352 patients who underwent percutaneous closure of ductus arteriosus, in 13 subjects complete closure failed (coils and Rashkind occluders were used in 10 and 3 patients, respectively). In these patients other percutaneous interventions aiming at total closure of residual shunt were attempted.
Results: In 12 patients coils were inserted (one patient received two coils). Introduction of implant in one patient failed, but total occlusion of the shunt was confirmed one day after the procedure. Trivial residual shunt was observed in one patient after one-year follow-up.
Conclusions: Percutaneous treatment of residual shunts within the ductus arteriosus is an effective and safe procedure. In our opinion identifying and treating such leaks is important, as it prevents complications and long-term need for antibiotic prevention of infective endocarditis. In the case of a small residual shunt, insertion of a coil seems to be the optimal therapy due to the low cost of the device, favourable design and high effectiveness. For patients in whom anatomy of the ductus arteriosus has been significantly changed, particularly in previously treated subjects, techniques using vascular loops or insertion using a catheter wedge may be helpful.

Abstract


Introduction: Restoration of blood flow through a previously occluded ductus arteriosus may occur in some patients. Treatment strategy in patients with such residual shunts has not yet been uniformly established.
Aim: To present single-centre experience and to attempt to establish a strategy of management of patients with residual ductus arteriosus shunts following percutaneous closure.
Methods: Of 352 patients who underwent percutaneous closure of ductus arteriosus, in 13 subjects complete closure failed (coils and Rashkind occluders were used in 10 and 3 patients, respectively). In these patients other percutaneous interventions aiming at total closure of residual shunt were attempted.
Results: In 12 patients coils were inserted (one patient received two coils). Introduction of implant in one patient failed, but total occlusion of the shunt was confirmed one day after the procedure. Trivial residual shunt was observed in one patient after one-year follow-up.
Conclusions: Percutaneous treatment of residual shunts within the ductus arteriosus is an effective and safe procedure. In our opinion identifying and treating such leaks is important, as it prevents complications and long-term need for antibiotic prevention of infective endocarditis. In the case of a small residual shunt, insertion of a coil seems to be the optimal therapy due to the low cost of the device, favourable design and high effectiveness. For patients in whom anatomy of the ductus arteriosus has been significantly changed, particularly in previously treated subjects, techniques using vascular loops or insertion using a catheter wedge may be helpful.
Get Citation

Keywords

persistent ductus arteriosus; interventional catheterisation; ductus arteriosus recanalisation

About this article
Title

Original article
Percutaneous closure of recanalised ductus arteriosus – a single-centre experience

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 2 (2007)

Pages

125-129

Published online

2007-02-23

Bibliographic record

Kardiol Pol 2007;65(2):125-129.

Keywords

persistent ductus arteriosus
interventional catheterisation
ductus arteriosus recanalisation

Authors

Jacek Kusa
Małgorzata Szkutnik
Jacek Baranowski
Eloa Adams
Blandyna Karwot
Jarosław Rycaj
Ireneusz Haponiuk
Jacek Białkowski

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