Safety of percutaneous patent ductus arteriosus closure: an unselected multicenter population experience. J Am Heart Assoc 2013 Nov 27;2(6):e000424
Date
11/29/2013Pubmed ID
24284214Pubmed Central ID
PMC3886754DOI
10.1161/JAHA.113.000424Scopus ID
2-s2.0-84902301281 (requires institutional sign-in at Scopus site) 63 CitationsAbstract
BACKGROUND: The technique and safety of transcatheter patent ductus arteriosus (PDA) closure have evolved during the past 20 years. We sought to report a multicenter experience of PDA closure with a focus on the rate of adverse events (AE) and a review of institutional practice differences.
METHODS AND RESULTS: Outcome data on transcatheter PDA closure were collected at 8 centers prospectively using a multicenter registry (Congenital Cardiac Catheterization Project on Outcome Registry). Between February 2007 and June 2010, 496 PDA closures were recorded using a device in 338 (68%) or coils in 158 (32%). Most patients had an isolated PDA (90%). Fifty percent of patients were between 6 months and 3 years old, with only 40 patients (8%) <6 months old. Median minimum PDA diameter was 2.5 mm (range 1 to 12 mm; IQR 2 to 3 mm) for device closure and 1 mm (range 0.5 to 6 mm; IQR 1 to 2 mm) for coil closure (P<0.001). A device rather than coil was used in patients <3 years, weight <11 kg, and with a PDA minimum diameter >2 mm (all P<0.001). Three of 8 centers exclusively used a device for PDAs with a diameter >1.5 mm. In 9% of cases (n=46), an AE occurred; however, only 11 (2%) were classified as high severity. Younger age was associated with a higher AE rate. Coil-related AEs were more common than device-related AEs (10% versus 2%, P<0.001).
CONCLUSIONS: PDA closure in the present era has a very low rate of complications, although these are higher in younger children. Technical intervention-related events were more common in coil procedures compared with device procedures. For PDAs ≤2.5 mm in diameter, institutional differences in preference for device versus coil exist.
Author List
El-Said HG, Bratincsak A, Foerster SR, Murphy JJ, Vincent J, Holzer R, Porras D, Moore J, Bergersen LAuthor
Susan Foerster MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Age Factors
Body Weight
Cardiac Catheterization
Child
Child, Preschool
Ductus Arteriosus, Patent
Female
Humans
Infant
Male
Patient Safety
Patient Selection
Practice Patterns, Physicians'
Prospective Studies
Registries
Risk Factors
Treatment Outcome
United States
