Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2014, 23(2):126-132

Long-term outcome and complications after catheter closure of persistent arterial duct

Tittel P1, Kaldarárová M1, Brucknerová I2, Mašura M3
1 NÚSCH a.s. - Detské kardiocentrum, Bratislava
2 I. Detská klinika LF UK a DFNsP, Bratislava
3 Klinika detskej kardiológie LF UK, NÚSCH a.s. - Detské kardiocentrum, Bratislava, Slovenská republika

Introduction: Catheter closure is the world-wide method of choice in the management of persis­ tent arterial duct beyond newborn age. According to the size and duct morphology the type of device is chosen during the procedure. The aim of the study was to analyze the long-term outcome and complications according to different devices used.

Patients and methods: Presented are 456 patients (67.3% female/32.7% male) after catheter closure of persistent arterial duct in NÚSCH - Children´s Cardiac Center between 1996-2012. Patients were grouped as follows: 150 patients with the coil closure (COIL), 178 patients with Amplatzer ductal occluder (ADO) and 128 patients with Amplatzer ductal occluder type II. (ADO II) closure. Long-term follow-up was considered up to 10 years (with median follow-up 4.5 years).

Results: Closure effectiveness was high in all three groups of patients. In long-term follow-up in the COIL group complete closure was found in 94,7% of patients, in ADO and ADO II groups it was 100%. The incidence of complications during the follow-up period was low. There was left pulmonary artery obstruction 3.3% of patients in the COIL group, in the ADO group 5.0% and 3.1% in the ADO II group of patients. Obstruction of the aortic isthmus in the COIL group was present in 0% of patients, in the ADO group 5.1% and in the ADO II group in 4.7% of patients. Overall reinterventions were needed in 5 patients (1.1%): in the COIL group in 4 patients (in 1 patient due to residual leak, in 2 due to left pulmonary artery obstruction, in 1 due to coil embolisation immediately after closure), in the ADO group in 1 patient (due to incorrect occluder position 24 hours after closure) and in the ADO II group no intervention was needed.

Conclusions: Results in the follow-up group prove that catheter closure of persistent arterial duct is a highly effective method with low incidence of complications in short-, as well as long-term, follow-up. This method can therefore successfully replace surgery in most patients beyond the newborn period.

Keywords: persistent arterial duct; catheter closure; coil; Amplatzer septal occluder; Amplatzer septal occluder type II.

Published: February 1, 2014  Show citation

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Tittel P, Kaldarárová M, Brucknerová I, Mašura M. Long-term outcome and complications after catheter closure of persistent arterial duct. Cardiology Letters. 2014;23(2):126-132.
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