Comparison of the results of transcatheter closure of patent ductus arteriosus with newer Amplatzer devices.

OBJECTIVES

To compare the success and complication rates for the different devices and patent ductus arteriosus (PDA) types.

BACKGROUND

There are numerous devices available for transcatheter closure of PDA but data comparing the success and complication rates of the newer devices are lacking.

METHODS

A retrospective review was undertaken of all cases of transcatheter PDA closure at a tertiary referral center.

RESULTS

Transcatheter PDA closure was achieved in 176 of 177 cases. Mean age, weight, and minimum ductal diameter were 3.3 years, 15.0 kg, and 2.5 mm, respectively. Devices used were Amplatzer Duct Occluder I (ADO I, 50.3%), Amplatzer Duct Occluder II (ADO II, 28.2%), Amplatzer Duct Occluder II Additional Sizes (ADO II AS, 5.1%), flipper coils (14.1%), and "other" devices (2.3%). Regarding Amplatzer devices, arterial delivery had a significantly shorter fluoroscopy time as compared to venous delivery (3.7 vs. 5.0 min, P = 0.0068), with no significant difference in outcomes. Immediate residual shunt rates were 7.9% (7/89) for ADO I, 4.1% (2/49) for ADO II, 11.1% (1/9) for ADO II AS, and 0% (0/25) for flipper coils. Aortic protrusion rates were 9% (8/89) for ADO I, 14.3% (7/49) for ADO II, and O% for both ADO II AS (0/9) and flipper coils (0/25).

CONCLUSIONS

All devices achieved excellent occlusion rates with low complication rates, regardless of PDA type. Device delivery via arterial access was associated with a shorter fluoroscopy time as compared to venous delivery, with no significant difference in outcomes. ADO II AS may be preferable to ADO II in the younger infant.