Catheter occlusion of the persistently patent ductus arteriosus.

Abstract

Catheter occlusion of a persistently patent ductus arteriosus was attempted in 40 patients (11 men and 29 women, mean age 7.2 +/- 8.3 years, range 244 days to 40 years), using a transvenously placed Rashkind umbrella occluder (USCI). Thirty-one 12-mm and six 17-mm diameter devices were successfully placed in the ductus (internal diameter average 3.9 mm, range 2 to 9 mm). One procedure was abandoned when fluoroscopy failed to visualize the device. There were 2 immediate embolizations subjected to surgical recovery. A residual shunt was present on the immediate postocclusion ventriculogram in 12 of 37 procedures (32%). Twenty-eight patients (75%) have had at least a follow-up at 3 months with Doppler study and 6 (21%) continued to have shunting into the pulmonary artery. Three of 4 patients have undergone successful placement of a second device and 1 patient's shunting spontaneously resolved at 1 year postimplant, leaving only 2 patients (7%) with persistent shunts. There has been 1 episode of probable prosthetic endarteritis and 1 patient has developed mild narrowing of the left pulmonary artery related to device placement. Catheter occlusion of the patent ductus arteriosus using the Rashkind umbrella appears to be a safe and effective method of non-surgical management.

• Authors: J D Dyck, L N Benson, J F Smallhorn, P R McLaughlin, R M Freedom, R D Rowe
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 62 Issue 16 Pg. 1089-92 (Nov 15 1988) ISSN: 0002-9149 [Print] United States
• PMID: 3189172 (Publication Type: Journal Article)

Topics

• Adult
• Catheterization (methods)
• Child
• Ductus Arteriosus, Patent (therapy)
• Echocardiography, Doppler
• Embolization, Therapeutic
• Female
• Humans
• Male