[Echocardiographic assessment of early and midterm results of transcatheter closure of a narrow patent ductus arteriosus in children].

This paper presents the echocardiographic assessment of early and midterm results of transcatheter closure of a narrow patent ductus arteriosus (PDA) in children using Jackson and Gianturco coils. The preliminary criterion for qualifying patients for the procedure was the PDA diameter (< or = 4 mm) at the narrowest site, as assessed echocardiographically. The criterion was met by 22 of 116 children with PDA treated at the Department of Pediatric Cardiology, Faculty of Medicine, Jagiellonian University, between January 1, 1996 and December 31, 2000. Angiography revealed, that in one case, the PDA diameter was larger (6.5 mm) and the patient required two Gianturco coils. Of 22 patients (8 males and 14 females) aged 2.7-16 years (x = 6.5 +/- 3.8), the procedure was successful in 21 children (95.5%). One patient with PDA was referred to the surgical department due to complications (the coil was displaced to the periphery of the left pulmonary artery and required removal by an Amplatzer device). The analysis of the follow-up echocardiography performed within 48 hours after the procedure and 1, 6, 12, 24 and 48 months later, revealed immediate total PDA closure in 29% of children. In 33% of patients, the PDA closed within 24 months. One child did not report to follow-up, however, the others are asymptomatic and show residual negligible shunts. The authors determined that the incidence and time of closure of residual shunts is dependent on the magnitude of the left-to-right shunt before the procedure.