Transcatheter closure of patent ductus arteriosus using detachable spring coils.

OBJECTIVE

To report our experience with transcatheter PDA closure using detachable spring coils.

METHODS

Suitable patients who presented between March 1996 to July 1997 were selected for coil occlusion of PDA after the diagnosis is confirmed on colour doppler echocardiography. Twenty-seven patients underwent an attempt at transcatheter closure of PDA with coils. Twenty-one were native ducts while 6 were residual ductal leaks following surgical ligation (4) and Rashkind umbrella occlusion (2).

RESULTS

The patients' age ranged from 20 months to 39 years (median 5.5 years) and weighed from 10.5 kg to 49 kg (median 21 kg). The PDA diameter ranged from 1.3 mm to 5 mm (mean 2.4 mm). Twenty-four patients had coils successfully deployed (one coil in each patient) and all had PDA diameter of < or = 3.5 mm. Seventeen had complete occlusion on echocardiographic colour doppler assessment within 24 hrs. Follow-up colour doppler assessment showed complete occlusion in all 24 patients by 6 months. There were no cases of coil embolisation or any other complications. Unsuccessful coil deployment was encountered in 3 patients with PDA diameter of > or = 4 mm.

CONCLUSION

The detachable coil system allows for complete control over coil release and therefore deployment is precise and complications are minimised. Transcatheter closure of PDA with the detachable coil is a safe and effective method especially for small ducts (< or = 3.5 mm).