Faculty Collaboration Database

Comparison of two transcatheter device strategies for occlusion of the patent ductus arteriosus. Catheter Cardiovasc Interv 2008 Nov 01;72(5):675-80

Date

10/23/2008

Pubmed ID

18942128

DOI

10.1002/ccd.21669

Scopus ID

2-s2.0-58749111104 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

OBJECTIVES: The present study evaluates two transcatheter closure strategies utilized at a single center and makes recommendations for device selection when occluding the patent ductus arteriosus.

BACKGROUND: A variety of devices are available for transcatheter closure of the patent ductus arteriosus (PDA) but no guidelines exist to guide operator device choice.

METHODS: A total of 132 patients underwent attempted transcatheter PDA closure utilizing one of two consecutive closure strategies between January 2000 and June 2005. Strategy A (n = 64; January 2000-May 2003) utilized Gianturco coils only. Strategy B (n = 68; June 2003-June 2005) utilized a single Gianturco coil for the PDA with a minimal diameter <or=1 mm (n = 28) or an Amplatzer Duct Occluder (ADO) if the PDA diameter exceeded 1 mm (n = 40). Success was defined as complete occlusion on a follow up echocardiogram.

RESULTS: 58 of 64 (90.6%) patients treated utilizing strategy A had successful coil implantation. 68 of 68 (100%) patients treated utilizing strategy B had successful coil/device implantation. At follow up echocardiography, 32 of 44 (72.7%) strategy A patients had complete ductal closure, as compared with 57 of 58 (98.3%) strategy B patients (P < 0.0001). Stepwise logistic regression analysis identified closure strategy as the most powerful predictor of procedural success (OR = 85.9; CI 5.6-9.99).

CONCLUSIONS: A transcatheter PDA closure strategy consisting of a single Gianturco coil for PDA <or= 1 mm or an ADO for larger sized PDA (strategy B) achieves superior outcomes compared to the use of coils alone.

Author List

Gudausky TM, Hirsch R, Khoury PR, Beekman RH 3rd

Author

Todd M. Gudausky MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cardiac Catheterization
Child
Child, Preschool
Ductus Arteriosus, Patent
Equipment Design
Humans
Infant
Infant, Newborn
Logistic Models
Odds Ratio
Patient Selection
Practice Guidelines as Topic
Radiography
Risk Assessment
Treatment Outcome
Ultrasonography