Plug closure of patent ductus arteriosus by transfemoral catheter method. A comparative study with surgery and a new technical modification.

Plug closure of patent ductus arteriosus without thoracotomy is reliable and can be a good alternative to surgical closure for selected patients. We report our experiences with plug closure in 87 consecutive patients (age range, 3 to 38 years). Closure was successful in 83 patients (95 percent). There has been no mortality, and the failure in four patients (5 percent) was mainly due to an oversized ductus. A major complication during the procedure was dislodgment of the plug into either the aorta or the pulmonary artery, which occurred in five patients (6 percent). The late results were quite satisfactory, with no recurrence of shunting or any other complications. Comparison of these results with those of 100 patients treated surgically showed that the new catheter method did not seem to carry a higher risk but had certain advantages over thoracotomy. A simpler and less time-consuming method using a single catheter has been devised and successfully used in the most recent nine patients without failure. Simplification of the technique has signficantly reduced the time of the procedure and the dose of radiation.